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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408982
Report Date: 02/02/2023
Date Signed: 02/02/2023 09:56:19 AM

Document Has Been Signed on 02/02/2023 09:56 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SANGIRAGCHAA, ERDENEDALAIFACILITY NUMBER:
073408982
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
02/02/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Erdenedalai SangiragchaaTIME COMPLETED:
10:00 AM
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On 2/2/23 at 9:25 AM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced case management for Plan of Correction. LPA met with the licensee Erdenedalai Sangiragchaa and discussed the purpose of the inspection. Licensee has a Small Family Child Care Home with a capacity of 8. Present for the inspection were licensee, licensee's assistant, 1 infant and 5 preschool children.

During the inspection operations of a family childcare home were discussed. Letter of Deficiency Citation Cleared was given to licensee for Type A cited on 1/24/23 for Staffing Ratio and Capacity.

There were no deficiencies cited during today's inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Erdenedalai Sangiragchaa.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2023
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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