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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500485
Report Date: 09/28/2021
Date Signed: 09/28/2021 10:19:10 AM

Document Has Been Signed on 09/28/2021 10:19 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:YCOE MARGUERITE MONTGOMERYFACILITY NUMBER:
574500485
ADMINISTRATOR:GENET TELAHUN/SILVIA MEZAFACILITY TYPE:
850
ADDRESS:1441 DANBURY STREETTELEPHONE:
(530) 668-3010
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 48TOTAL ENROLLED CHILDREN: 0CENSUS: 14DATE:
09/28/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Maria CardenasTIME COMPLETED:
10:30 AM
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Application Specialist (AS) Alecia Sifuentes met with Administrative Secretary, Maria Cardenas for the purpose of an announced case management inspection to remeasure the outdoor play area due to the Licensee decreasing the square footage.

The outdoor play area is currently fenced with temporary fencing that is at least four feet tall and fully surrounds the play yard. Licensee is awaiting delivery of permanent fencing and installation. AS remeasured the outdoor activity space. The outdoor play area contains a total of 1,885.971 square feet, which will only accommodate 25 preschool children. Licensee has requested an Insufficient Outdoor Space Waiver. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

This facility evaluation report was reviewed and discussed with Licensee. Licensee was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

The facility currently holds a provisional license that will expire in 90 days on 11/23/2021. The following items are to be submitted prior to expiration of the provisional license for final approval of license:
1. Remaining documents listed on LIC184.
2. Proof of permanent playground fencing.
3. Final file review from Licensing Program Manager (LPM) Justin Denton.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2021
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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