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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483008718
Report Date: 04/03/2024
Date Signed: 04/03/2024 03:01:28 PM

Document Has Been Signed on 04/03/2024 03:01 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:CLAVERIE, CLAUDIA FCCHFACILITY NUMBER:
483008718
ADMINISTRATOR:
ADMINISTRATOR/
DIRECTOR:		CLAVERIE, CLAUDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 704-7221
CITY:BENICIASTATE: CAZIP CODE:
94510
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 9DATE:
04/03/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
TIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Claudia Claverie TIME COMPLETED:
TIME VISIT/
INSPECTION COMPLETED:
02:19 PM
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A visit was made today by Licensing Program Manager Alexis Hollon and Licensing Program Analyst Yang Yang. The visit was conducted to serve a Temporary Suspension Order (TSO) and Exclusion Letter for Claudia Claverie, initiated by the Department effective today, 4/03/24. The TSO packet was reviewed with the licensee.
The following documents were provided to the Licensee:

1. Temporary Suspension Order (TSO)

2. Statement to Respondents

3. Government Code Sections

4. Summary Instructions for Licensee

5. Summary of Charges

6. Accusation

7. Request for Discovery

8. Notice of Defense (2)

9. Immediate Exclusion

The licensee was informed that while the order is in effect, she is prohibited from operating the child day care facility. The written notice of the TSO was taped on the outside of the front door, is readily visible to the parents or guardians of children in care and must remain as long as the order is in effect. Licensee was informed that removal of this notice constitutes a violation of the law, a misdemeanor fine of up to $500.00. The licensee shall post and provide copies of this licensing report to all parents/guardians and must give a copy of the Summary of Charges to the parent or legal guardian of each child receiving services in the facility until the Accusation is either dismissed or resolved through the administrative process or Stipulated agreement. Each parent/guardian receiving a copy of the Summary of Charges shall sign and date form LIC9224, Acknowledgement of Receipt of Licensing Reports; copy was given to Claudia Claverie.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/03/2024
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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