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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293624965
Report Date: 12/19/2024
Date Signed: 12/19/2024 01:51:09 PM

Document Has Been Signed on 12/19/2024 01:51 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:YOUKHEHPAZ, DOMINIQUEFACILITY NUMBER:
293624965
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
12/19/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Dominique YoukhapezTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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At 12:40pm on 12/19/2024, Licensing Program Analyst (LPA) Matthew Gallo met with licensee Dominique Youkhapez to conduct an unannounced change of capacity inspection. The licensee is requesting an increased capacity from 8 to 14 children. Today's census included 6 preschool children. Criminal record clearances were verified.

A health and safety inspection was conducted in all areas of the home used for care. Off-limits areas include Master Bedroom/Bath and all outbuildings. Licensee acknowledged that children must never enter these areas. LPA observed the required postings, a working phone, 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors. All hazardous items and chemicals are inaccessible to children. Pellet burning furnace is properly barricaded. Firearm weapons and ammunition are stored and locked separately as required by regulation. There are natural swamps on the property, and LPA observed a fenced play yard with a 5 ft tall fence that does not obstruct the view and features self-latching and self-closing gates that open outward. Licensee acknowledges that 100% supervision is required in all unfenced areas of the property.

Overall, LPA observed the home to be clean, safe, sanitary, and in good repair with appropriate toys for children. In the areas that were evaluated during today's inspection, the facility is in compliance with regulations.

The licensee has been APPROVED to operate as a Large Family Child Care Home with a maximum capacity (when there is an assistant present) of 12 children with no more than four infants OR a capacity of 14 children no more than three Infants; one child must be in Transitional Kindergarten/Elementary School and one child must be at least six years old. If there is not an assistant present, the facility must revert to the ratio and capacity required by a Small Family Child Care Home license.

Exit interview conducted and report was reviewed with the licensee, Dominique Youkhapez. A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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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