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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500684
Report Date: 12/01/2022
Date Signed: 12/01/2022 10:17:56 AM

Document Has Been Signed on 12/01/2022 10:17 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:MADDOX, HOWARD & KARLAFACILITY NUMBER:
394500684
ADMINISTRATOR:MADDOX, HOWARD & KARLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 988-1236
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/01/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Karla MaddoxTIME COMPLETED:
10:40 AM
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On 12/01/22 Licensing Program Analysts (LPAs) Elvira Sierra and Corina Beckby conducted a follow up prelicensing visit and met with applicant, Karla Maddox.

The purpose of the inspection was to inspect the hot tub located in the backyard. Hot tub was observed to have a cover that is locked down and no parts of the cover can be lifted more than 4" off the hot tub and the the hot tub cover locking mechanism has a lock that requires a key to unlock. LPAs advised that hot tub must be always lock during daycare hours and the cover and locking mechanism must always be in good repair. LPAs also verified that electrical cords in the TV room are inaccessible to children and left and right side of the backyard is inaccessible.

Effective today December 01, 2022, the facility is licensed to serve a MAX. CAP: 6 - NO MORE THAN 3 INFANTS OR 4 INFANTS ONLY. CAP 8 - NO MORE THAN 2 INFANTS, 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

Exit interview conducted and report was reviewed with the Applicant, Karla Maddox.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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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