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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313617082
Report Date: 02/07/2024
Date Signed: 02/07/2024 02:39:59 PM

Document Has Been Signed on 02/07/2024 02:39 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:LAKE, AKIKOFACILITY NUMBER:
313617082
ADMINISTRATOR:LAKE, AKIKOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 316-1523
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
02/07/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Akiko LakeTIME COMPLETED:
03:00 PM
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On February 7, 2024 Licensing Program Analyst (LPAs) Lea Habtom and Matthew Gallo arrived at Akiko Lake's family childcare home. LPAs conducted a case management inspection with licensee, Akiko Lake. The purpose of this case management is to clear the citation issued on February 1, 2024 for licensee being unable to unlock the safe for the weapons to confirm that the weapons and ammunition are locked and stored separately.

There was a census of 2 infants and 2 preschool children being supervised by licensee and her assistant. Licensee's two adult son's were also present in the home at the time of the inspection. All adults have fingerprint clearances and associations.

No Title 22 regulations were cited during today's inspection. Based on today's inspection, LPAs have cleared the Type A citation issued on February 1, 2024 and provided licensee with a cleared plan of correction letter.

This report was reviewed with licensee, Akiko Lake. A notice of site visit was provided to be posted for 30 days. Appeal rights provided.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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