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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483007332
Report Date: 07/06/2022
Date Signed: 07/06/2022 02:00:57 PM

Document Has Been Signed on 07/06/2022 02:00 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:TATHAM, ROBIN FAMILY CHILD CARE HOMEFACILITY NUMBER:
483007332
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
07/06/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Robin TathamTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with Robin Tatham to conduct a capacity increase. The application for the capacity increase was received by the department on June 16, 2022. The fire clearance was granted during the Covid-19 waiver on Sept 4, 2020.

LPA Ouye verified that the facility has a fire extinguisher rated at 2A10BC. The smoke and carbon monoxide detectors are integrated into the facility alarm system.

LPA Ouye discussed and provided the licensee with safe sleep regulations, safe sleep log and individual sleep plan for infants. The LIC311D form showing the required records was also given to the licensee.

The licensee conduct emergency disaster drills every three months and documents the drills.

The facility is now approved to operate as a large Family Child Care Home effective today, July 6, 2022. LPA Ouye will send an updated license reflecting the increased capacity.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 07/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2022
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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