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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009764
Report Date: 11/22/2022
Date Signed: 11/22/2022 03:53:24 PM

Document Has Been Signed on 11/22/2022 03:53 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:MEYER, SABRINA FCCHFACILITY NUMBER:
493009764
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
11/22/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Sabrina MeyerTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with licensee Sabrina Meyer to conduct a capacity increase visit. The fire inspector conducted the fire safety clearance earlier in the day. The licensee said that the fire inspector is requiring her to change her front door lock assembly and install a carbon monoxide detector in the rear unit.

There are functioning smoke and carbon monoxide detectors and a fire extinguisher rated at 2A10BC.

The licensee will be working with the fire inspector to meet the fire code requirements. Upon receipt of the approved fire clearance from the local fire authority, the facility will be approved as a large FCCH.

No deficiencies during the visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2022
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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