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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394501105
Report Date: 07/02/2024
Date Signed: 07/02/2024 11:34:22 AM

Document Has Been Signed on 07/02/2024 11:34 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:PEREZ, YENYFACILITY NUMBER:
394501105
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
07/02/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Yeny PerezTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 7/2/24, Licensing Program Analyst (LPA) Carla Polanco conducted a follow up pre-licensing visit and met with applicant, Yeny Perez.

The purpose of today's inspection was to verify the corrections that were requested on an inspection visit dated 6/12/24, in which LPA observed a pool in the backyard which due to deficiencies of the pool gate did not meet tittle 22 regulations. LPA observed windows that were in an accessible area of the pool. During the inspection applicant was advised to move gate and exclude the windows in the area with access to the pool.

During today's inspection, LPA observed a fence bordering the pool. The fence was observed to be at least five feet high and did not obscure the body of water from view. The gate swings away from the body of water, with a self close and self latching device.

On today's date 7/2/24, the facility has been approved for a Small Family Child Care Home license for a capacity of 8 children with no more than 3 infants, or 4 infants only, or up to 8 children with no more than 2 infants, 1 child in Transitional Kindergarten or above, and 1 child at least age 6. Infants are children under the age of 2.

An exit interview was conducted and the report was reviewed with Applicant. A notice of site visit was posted by LPA and appeal rights were provided.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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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