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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621199
Report Date: 02/08/2023
Date Signed: 02/08/2023 10:41:07 AM

Document Has Been Signed on 02/08/2023 10:41 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:JARA, SANDRAFACILITY NUMBER:
393621199
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
02/08/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Sandra JaraTIME COMPLETED:
10:55 AM
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On 2/08/23 Licensing Program Analyst (LPA) Elvira Sierra conducted a Case Management visit for the purpose of increasing the licensed capacity from 8 to 14 children. LPA met with Licensee, Sandra Jara. Fire Safety Inspection Clearance was granted on 02/07/23 for a total capacity of 14 children. Facility hours of operation are 07:30 am – 5:30 pm M-F. All individuals subject to criminal background review have obtained a criminal record clearance. LPA observed Licensee caring for one child.

A health and safety inspection was conducted in all areas accessible to children. Home appears orderly and suitable for children. Off-limits areas include; All bedrooms, garage, laundry room. Hazardous items were stored inaccessible to children. Napping equipment and age appropriate toys were observed. Licensee stated there are no weapons in the home and no bodies of water were observed. Home as a working telephone, 2A10BC fire extinguisher and a functioning smoke and carbon monoxide detectors. Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.



LPA reviewed large family childcare home capacity limitations with licensee. Capacity increase is approved as of Today, 02/08/23. The facility is licensed to serve a MAX. CAP(WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

A notice of site visit was posted and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Sandra Jara.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/08/2023
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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