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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009394
Report Date: 03/19/2025
Date Signed: 03/19/2025 09:45:52 AM

Document Has Been Signed on 03/19/2025 09:45 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:HAND, JORDAN FCCHFACILITY NUMBER:
483009394
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
03/19/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Jordan HandTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 03/19/2025, Licensing Program Analyst (LPA), Selena Mariani conducted a Case Management Visit regarding Licensee requesting for an increase of capacity to 14 daycare children and met with Licensee, Jordan Hand. Prior to visit, Licensee received a Fire Safely Inspection conducted by the local fire department and LPA received an approved STD 850 on 01/28/2025.
During the inspection the home was toured inside and outside. The licensee was supervising 2 children and operating within the licensed capacity and ratio requirements. The facility’s operating hours are Monday – Thursday 7:00am - 5:00pm. The floor plan submitted by the licensee was reviewed and verified. Licensee was reminded that an assistant must be present when the capacity is over 8 daycare children. Also, that the children shall be supervised by a staff member with a current Pediatric CPR and First Aid Certification issued by American Red Cross or the American Heart Association, or by approved Emergency Medical Services Authority (EMSA) vendor. Licensee has met the requirements to increase her capacity and has been approved.

Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Exit interview conducted and report was reviewed with the Licensee, Jordan Hand.
There were no Title 22 deficiencies cited during today's inspection.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Selena Mariani
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2025
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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