<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 475407415
Report Date: 01/26/2022
Date Signed: 01/28/2022 08:41:34 AM

Document Has Been Signed on 01/28/2022 08:41 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:ROCHA, PAMELA FAMILY CHILD CARE HOMEFACILITY NUMBER:
475407415
ADMINISTRATOR:ROCHA, PAMELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 357-9432
CITY:GREENVIEWSTATE: CAZIP CODE:
96037
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
01/26/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Pamela RochaTIME COMPLETED:
04:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
The Licensing Program Analyst conducted a facility inspection to inspect the pool fencing. The non climbable fencing fully surrounds the above ground pool at 5 feet. The view of the pool was not obstructed. The pool was not filled today.


5 children were being supervised by 2 staff.

No violations observed.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1