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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103910958
Report Date: 05/18/2021
Date Signed: 05/18/2021 10:58:22 AM

Document Has Been Signed on 05/18/2021 10:58 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:GRAHAM, KENDRA FAMILY CHILD CAREFACILITY NUMBER:
103910958
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
05/18/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kendra GrahamTIME COMPLETED:
10:30 AM
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
On 05/18/2021, Licensing Program Analyst (LPA) Luisa Gavoutian conducted a scheduled case management tele-visit. An in-person inspection was not conducted due to COVID-19 pandemic restrictions. LPA connected with Licensee Kendra Graham via FaceTime. Licensee provided LPA a virtual tour of the home. Present at the home were eight children. The purpose of today's tele-visit was to license one bedroom for daycare use.

LPA virtually toured bedroom #3. The bedroom will be used for napping. LPA observed in the room a changing table, a rocking chair with foot rest, a crib, and age appropriate children's toys. LPA observed all the electrical outlets had plug covers installed. Licensee plans to place a play yard in the room to be utilized for napping. Children will not be using the room when not napping and LPA observed a doorknob spinner installed on the door.

The areas of the home that are accessible to daycare children are the living room, dining room, kitchen, bedroom #1 (daycare room), bedroom #3, and hallway bathroom. Licensee understands her responsibility to provide care and supervision. Licensee is aware of, and following infant safe sleep regulations.

Licensee to update the facility sketch and submit a copy to Community Care Licensing (CCL) within 14 days.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

This report shall be made available to the public upon request.
SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2021
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