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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623990
Report Date: 09/22/2023
Date Signed: 09/22/2023 01:59:06 PM

Document Has Been Signed on 09/22/2023 01:59 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:BOOKER, SARAHFACILITY NUMBER:
343623990
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/22/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Sarah BookerTIME COMPLETED:
02:30 PM
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On Friday, September 22, 2023, Licensing Program Analyst (LPA) Amanda Sutter met with licensee Sarah Booker for the purpose of a Capacity Increase from 8 to 14 children. The Fire Safety Inspection Clearance has been received from the Nevada County Fire Department on August 14, 2023 and the home has been cleared for up to 14 children. All individuals subject to criminal background review have obtained a criminal record clearance. One child was present in the facility.

A health and safety evaluation was conducted in all areas accessible to children. The home is two stories. Off-limit areas include: all downstairs bedrooms, garage, laundry room, and entire upstairs. Licensee acknowledged that children may never enter these off-limit areas. Licensee acknowledged that children may never enter these off-limit areas. LPA observed a current roster of the enrolled children and fire drill log.

Large family child care home capacity limitations were reviewed during today's visit. Licensee acknowledges that when there is no assistant present, facility will revert back to the small capacity. Licensee acknowledges that children residing in the home under the age of 10 years shall be included in capacity

Effective today, September 22, 2023, LPA will approve the capacity increase to serve up to either 14 children, two (2) of which must be at least 6 years of age and no more than three (3) may be infants; or 12 children, four (4) of which may be infants. Infants are children under the age of 2.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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