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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455402479
Report Date: 09/17/2024
Date Signed: 09/17/2024 09:20:15 AM

Document Has Been Signed on 09/17/2024 09:20 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:MATTICE, STEPHANIE FAMILY CHILD CARE HOMEFACILITY NUMBER:
455402479
ADMINISTRATOR/
DIRECTOR:		MATTICE, STEPHANIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 440-9399
CITY:SHASTA LAKESTATE: CAZIP CODE:
96019
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
09/17/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:51 AM
MET WITH:Stephanie MatticeTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
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On 9/17/24 at 8:51am Licensing Program Analyst (LPA) Bianca Mendez, conducted a Case Management unannounced inspection relating to deficiencies discovered on 9/11/24. During the required annual year inspection, licensee did not have the correct pool fencing that met Title 22 regulations.. Licensee was issued a type A citation and immediate $500 dollar civil penalty. LPA had observed that there was above ground pool on the other side of the chainlink fence of the yard.
On 9/12/24, licensee submitted a plan of correction stating they would remove the pool and submitted proof that the pool was taken down and placed in shed.
During today's site visit it was verified that licensee did remove the above ground pool and is compliant with licensing regulations

The POC is cleared as of 9/17/24

This report was reviewed and discussed with licensee, Stephanie Mattice. Notice of Site Visit shall be posted for 30 days from today's visit. There were no Title 22 deficiencies cited during today's inspection
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2024
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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