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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623635
Report Date: 07/18/2022
Date Signed: 07/18/2022 10:23:12 AM

Document Has Been Signed on 07/18/2022 10:23 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:KOBLE-PROTHERO, REBECKAFACILITY NUMBER:
313623635
ADMINISTRATOR:KOBLE-PROTHERO, REBECKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 863-0024
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
07/18/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:TIME COMPLETED:
10:40 AM
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On July 18, 2022 around 9:40 am Licensing Program Analyst (LPA) Lea Habtom and Licensing Program Manager (LPM) Keven Peters conducted an unannounced case management inspection for the citation dated June 29, 2022. There was a census of 11 preschool children being supervised by licensee and her assistant. Licensee's spouse was also present at the home during the inspection. All adults in the home are fingerprint cleared.

LPA Habtom and LPM Peters inspected the gate surrounding the pool as well as the rock wall around the back yard. Licensee installed a wrought iron fence that is at least 5 feet tall with a self- latching locking system. The rock wall wraps around the yard and has a small section that is around 3-4 feet. Due to height of the rock wall, LPM Peters notified licensee to install the mesh fence to avoid access to that area for day care children. LPM Peters notified licensee that 100% supervision is required due to the construction of the brick wall. LPA Habtom will clear the citation for the pool fencing dated June 29, 2022 once licensee sends pictures of the mesh fence installed via email.

No Title 22 regulations were cited during today's visit. Notice of cite visit provided.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2022
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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