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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622905
Report Date: 06/03/2024
Date Signed: 06/03/2024 09:52:34 AM

Document Has Been Signed on 06/03/2024 09:52 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CRUZ MELENDEZ, DARIANAFACILITY NUMBER:
343622905
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
06/03/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Dariana Cruz MelendezTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Gagandeep Singh met with licensee, Dariana Cruz Melendez, for an inspection. The licensee submitted an application to increase the capacity from eight to fourteen children in care. The facility was inspected by fire department on May 28, 2024 and clearance was granted.

During today’s inspection, LPA inspected the facility for health and safety of the children. LPA observed the house has proper temperature and ventilation. There are no pools, spas, or other bodies of water on property. LPA observed the licensee has a working smoke alarm, carbon monoxide detector, telephone and fully charged fire extinguisher on site. Licensee has record of CPR training valid until October 2024 and Mandated reporter training until November 2025. During inspection, LPA discussed the regulations and requirements of large child care license with the licensee and provided a handout explain the ratio and capacity of children.

During today’s inspection, LPA did not observe any hazard in the house. Licensee has met all of the requirements and has provided all required documents. Therefore, as of today, the facility will be granted the license to operate with maximum capacity of fourteen children in care. Copy of this report was reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 06/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/03/2024
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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