<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 553616710
Report Date: 08/04/2021
Date Signed: 08/04/2021 01:17:01 PM

Document Has Been Signed on 08/04/2021 01:17 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:VICINI, ANITAFACILITY NUMBER:
553616710
ADMINISTRATOR:VICINI, ANITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 536-4098
CITY:SONORASTATE: CAZIP CODE:
95370
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
08/04/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Anita ViciniTIME COMPLETED:
01:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Manager (LPM) Justin Denton met with Licensee Anita Vicini for a case management inspection. The facility consists of 3 bedrooms, 2 bathrooms, living room, kitchen, and dining room. The main area for care is the living room, dining area, bedroom #1, and front yard. Off-limit areas include kitchen, entire upstairs, laundry room, bedroom #2, and detached garage. This inspection was conducted over video chat due to the ongoing COVID-19 pandemic.

Licensee Vicini is expanding facility to include bedroom #1, which she is converting to use for school age children to study. Licensee will ensure that the off-limits areas are inaccessible using child-proof covers on door-knobs or child-gates.

LPA virtually toured bedroom #2 and observed it to be free of hazards. Licensee has provided an updated facility sketch.

Exit interview conducted and appeal rights provided via email.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Justin L Denton
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1