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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500472
Report Date: 01/24/2022
Date Signed: 01/24/2022 02:07:31 PM

Document Has Been Signed on 01/24/2022 02:07 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:SAPRE, SARIKAFACILITY NUMBER:
394500472
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
01/24/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sarika Sapre TIME COMPLETED:
02:06 PM
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Licensing Program Analyst ( LPA ) Stacey Williams arrived to the facility for the purpose of conducting a case management inspection. LPA met with Licensee, Sarika Sapre. No childcare children were present during the inspection. Licensee informed LPA that a fire inspection was conducted to increase capacity of licensure. LPA toured the home and observed the fire alarm system. Fire clearance authorization has not been established through the fire prevention department to date. Once confirmation of clearance is received, a supplemental inspection will be conducted for the increase of capacity.


Exit interview was conducted and notice of site visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2022
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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