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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173010430
Report Date: 06/12/2024
Date Signed: 06/12/2024 10:40:09 AM

Document Has Been Signed on 06/12/2024 10:40 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:STILLMAN, VICKIE FCCHFACILITY NUMBER:
173010430
ADMINISTRATOR/
DIRECTOR:		STILLMAN, VICKIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 349-3588
CITY:UPPERLAKESTATE: CAZIP CODE:
95485
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
06/12/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:11 AM
MET WITH:Vickie StillmanTIME VISIT/
INSPECTION COMPLETED:
10:50 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 06/12/2024, at 10:11AM, Licensing Program Analyst, Sebastian Phouthavong made an announced Case Management visit to the facility and met with Licensee, Vickie Stillman to verify operation at the facility and to address the home’s swimming pool. Prior to visit, on 06/04/2024 during an inspection, Licensee notified LPA on the facility’s plan to update the fencing surrounding the backyard pool.

During the visit, LPA observed eight children in care being supervised by 2 staff. The home was toured inside and out. LPA observed an above ground pool and pond to be in the off-limits section of the backyard and is inaccessible to daycare children. LPA observed the fencing to be at least five feet high and be constructed so that the fence does not obscure the pool from view. The gates leading to the area has self-latching devices. Licensee stated she does not plan to use the pool during non-operating hours.

LPA observed that the facility has met the fencing requirements for any bodies of waters as of today’s visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Vickie Stillman.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2024
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