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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009888
Report Date: 01/12/2024
Date Signed: 01/12/2024 01:57:49 PM

Document Has Been Signed on 01/12/2024 01:57 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:REED, KYWANNA FCCHFACILITY NUMBER:
483009888
ADMINISTRATOR:REED, KYWANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 654-8563
CITY:VALLEJOSTATE: CAZIP CODE:
94590
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
01/12/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Adriane McKinneyTIME COMPLETED:
02:00 PM
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Licensing Program Analyst Glenn Ouye arrived to conduct a quarterly Legal/Non-Compliance case management visit with the facility for Kywanna Reed.
During the visit LPA met with two staff who were supervising eight children, one of which is an infant.

LPA Ouye verified that the facility is maintaining the safe sleep log for the infant who is 15 months old. The child was sleeping at the time of visit. The safe sleep regulations were being met for the infant in care.

Staff files and the licensee files were reviewed. All required documents were present including current first aid & CPR and mandated reporter training for all staff. Immunizations were verified.

The facility is operating within the child and staff ratio for a large family child care home.

No deficiencies were cited during the visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2024
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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