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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009279
Report Date: 09/22/2022
Date Signed: 09/22/2022 11:18:38 AM

Document Has Been Signed on 09/22/2022 11:18 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:WALKER, CHARMENA FCCHFACILITY NUMBER:
483009279
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 2CENSUS: 0DATE:
09/22/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Licensee Charmena WalkerTIME COMPLETED:
11:25 AM
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Licensing Program analyst ( LPA) Elpidia Hernandez Torres arrived at the facility for a capacity increase inspection. Licensee submitted increase of capacity application on 08/09/2022 and wishes to increase capacity from a small (8) family child care home to a large (14) family child care home. Fire Clearance was granted on 08/25/2022 and received by the department.

The home is a four bedroom, three bathroom, tri-level home. The off limits area of the home are the third level and all its rooms, the garage and bedroom on the first level of the home. These areas have been made in-accessible with child safety gates and/or door knob slip covers. The home has working smoke detector, carbon monoxide detector and fire extinguisher rated atleast 2A10BC. Licensee has all required certificates and trainings on file. Hours of operation will be 02:00PM- 06:00PM Monday- Friday. The children will have access to the back yard as the outdoor play area it is fully fenced. There are no bodies of water, pools, spas observed on the premises today.

LPA reminded Licensee when there is no assistant present, licensee shall comply with the capacity requirements for a Small Family Child Care Home. This licensee was grated increase of capacity from a small to a large Family child care home. Notice of site visit shall be posted for 30 days.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2022
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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