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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624239
Report Date: 03/23/2023
Date Signed: 03/23/2023 10:00:56 AM

Document Has Been Signed on 03/23/2023 10:00 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:ROJAS, MERCEDESFACILITY NUMBER:
343624239
ADMINISTRATOR:ROJAS, MERCEDESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 889-7701
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/23/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Meredes RojasTIME COMPLETED:
10:15 AM
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On 03/23/2023, Licensing Program Analysts (LPAs) Jeremey McClain and Carla Polanco Rivera conducted an announced follow-up change of location pre licensing inspection with applicant Mercedes Rojas. The original pre licensing inspection was conducted on 09/13/2022 by former LPA Fabiola Diaz.

The purpose of today’s follow up inspection was to view the applicant’s pool fence and hot tub cover. LPAs observed a mesh fence that is at least five feet high, however it does not have a self-latching gate. LPAs observed a hot tub that is built into the outside deck, with two of the eight sides of the cover locked. LPAs observed that there is a side of the cover that lifts more than 4 inches. LPAs also observed a mesh fence that is blocking a sliding glass door which is a point of egress.

LPA explained the following items would need to be corrected before LPAs return to make an inspection:
1) A self latching gate that opens away from the pool must be installed.
2) The mesh fencing blocking the point of egress must be removed.
3) Locks must be added to the hot tub to make it more secure where the top cannot be lifted.

This report was reviewed with the applicant and was translated in Spanish.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2023
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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