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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624205
Report Date: 06/01/2023
Date Signed: 06/01/2023 09:57:43 AM

Document Has Been Signed on 06/01/2023 09:57 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:COMBS, IVYANNEFACILITY NUMBER:
343624205
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
06/01/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Ivyanne CombsTIME COMPLETED:
10:15 AM
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On Thursday, June 1, 2023, Licensing Program Analysts (LPAs) Amanda Sutter and Pa Dao Vang met with licensee Ivyanne Combs for the purpose of a Capacity Increase from 8 to 14 children. The Fire Safety Inspection Clearance has been received from the Sacramento Metropolitan Fire District on May 26, 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. Four children were present in the facility.

A health and safety evaluation was conducted in all areas accessible to children. The home is two story. Upon arrival, licensee stated that she wished to place the kitchen and side yard off limits. LPAs observed these areas to be inaccessible to children, and were provided with an updated LIC999. Off-limit areas include: backyard, entire upstairs, laundry room, garage, bedroom and crawl space off laundry room, side yard, and kitchen. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated that she wishes to place the backyard on limits at this time. LPAs observed a play structure on top of concrete slabs in the backyard. The slab near the slide has sharp edges that pose a potential hazard to children in care. Licensee stated that she will submit photos proving that she has added cushioning to blunt the edges. LPAs will approve placing the backyard on limits following receipt of photos.

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, June 1, 2023, LPAs 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.

In the areas that were evaluated, no deficiencies were observed at the time of the visit. Exit interview conducted. Notice of site visit posted.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2023
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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