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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617989
Report Date: 12/06/2022
Date Signed: 12/06/2022 11:00:36 AM

Document Has Been Signed on 12/06/2022 11:00 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:NAVARRETTE, LORRAINEFACILITY NUMBER:
343617989
ADMINISTRATOR:NAVARRETTE, LORRAINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 613-3044
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
12/06/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Lorraine NavarretteTIME COMPLETED:
11:15 AM
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On December 6, 2022 at 10:05 am Licensing Program Analysts (LPAs) Lea Habtom and Amanda Blesi met with Licensee, Lorraine Navarrette, regarding a case management visit. During today's inspection licensee requested that the off limits areas be updated to reflect all bedrooms as off limits. The updated off limits area is now all bedrooms (3), garage and shed in backyard. Licensee was made aware that children may never enter these off limits areas. LPA L. Habtom made licensee aware to mail an updated facility sketch to reflect the off-limits areas.

No Title 22 deficiency cited during today's visit. Notice of site visit was provided to be posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2022
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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