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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624946
Report Date: 05/22/2023
Date Signed: 05/24/2023 10:16:17 AM

Document Has Been Signed on 05/24/2023 10:16 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:LOPEZ, JOANNAFACILITY NUMBER:
343624946
ADMINISTRATOR:LOPEZ, JOANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 406-9035
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
05/22/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Joanna LopezTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the applicant, Joanna Lopez, for a scheduled pre licensing inspection. Applicant had a license (343622139) at another location and applied for a new license due to change of location. Per applicant, applicant owns the new property at new location.

During today's inspection, LPA inspected the house for health and safety of children. Per applicant, day care will be provided between 7 AM to 5 PM in areas: On ground floor - Living room, Kitchen, Dining area, Bathroom and Backyard. Off limit areas are: Entire second floor and Garage. During inspection, LPA observed the house has proper temperature and ventilation. There are no pools, spas or other bodies of water. Per applicant, there are no firearms or weapons in the house. Cabinets in kitchen with chemicals and knives have child protective locks installed. The house has fully charged fire extinguisher, carbon monoxide detector, smoke alarms, first aid supplies box and working telephone. The stairs have child protective gates installed to keep them inaccessible for children. All unused electrical outlets have child protective covers installed. LPA did not observe any sharp objects or hazards in the back yard. Applicant has submitted all of the required documentation for the new license. Applicant has a valid CPR training certificate valid until June 2024.

During the inspection, LPA did not observe any hazard in the house and the house meets the requirements of the license. However, the applicant is pending on the approved fire clearance. As the applicant obtain the clearance from local fire department, the new license with capacity of 14 children will be granted. Copy of this report was reviewed and provided to the applicant.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2023
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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