<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624419
Report Date: 09/09/2022
Date Signed: 09/09/2022 09:38:15 AM

Document Has Been Signed on 09/09/2022 09:38 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:FRY, DEONNAFACILITY NUMBER:
343624419
ADMINISTRATOR:FRY, DEONNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 720-5173
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/09/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Deonna FryTIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
This is a Change of Location from previous facility number 343623727

Licensing Program Analyst (LPA) Kelly Ferrara conducted a Change of Location inspection and met with applicant Deonna Fry. LPA advised applicant that all adults living or working in the home must be fingerprint cleared and associated to her license. Facility hours of operation are Monday through Saturday 3:15 AM to 9:30 PM.

A health and safety inspection of the entire home was conducted. Applicant's home is a single story, three bedroom, one bathroom home, with an office in the outdoor area. Day care will mostly be provided in the room to the left of the kitchen. Off limit areas include: Master bedroom and garage. Applicant understands that children may not enter off limit areas and any changes made must be cleared through Licensing. Chemicals, knives, medications, and hazardous items are all stored in a way that is inaccessible to children. LPA advised that poisonous items must be locked. LPA observed the smoke and carbon monoxide detector are functioning properly. LPA observed a 2A-10-BC fire extinguisher. Applicant stated there are no firearms in the home and LPA did not observe any bodies of water on the premises.

The Facility Evaluation Report was reviewed and discussed with the Applicant. Applicant was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for information regarding PINs, child care updates, forms, regulations and legislation pertaining to family child care homes. LPA reviewed capacity requirements and limitations with the applicant.

As of today’s date, September 9th 2022, the new home is licensed and ready to operate.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1