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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009866
Report Date: 02/08/2024
Date Signed: 02/08/2024 09:57:54 AM

Document Has Been Signed on 02/08/2024 09:57 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:MOFFETT, MIRANDA FCCHFACILITY NUMBER:
483009866
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
02/08/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Miranda MoffettTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Glenn Ouye arrived unannounced to conduct quarterly Legal/Non-Compliance, Case Management inspection. LPA Ouye met with licensee Miranda Moffett.

The inspection is to confirm the continual compliance with the following issues:
· To treat the children in her care with dignity and respect, without the use of punishment that may negatively impact a child’s emotional and physical well-being.
· Train all existing staff and new hires on the requirements of Children’s Personal Rights and AB 1207 Mandated Reporter Training.
· Comply with requirements of parental rights which consist of allowing parents entry to inspect the facility’s on limits areas.
· Comply with capacity requirements of the license.
· Obtain additional staff and/or volunteers to assist in the care of the children when necessary.
· Adhere to the requirements of infant safe sleep.
· Maintain compliance with requirements of children’s immunization.

LPA Ouye was able to verify all of the above issues and conducted a record review for the one child that was present. The licensee's first aid/cpr certificate is valid through April 23, 2025. Her mandated reporter training certificate is valid to June 1, 2024.

The Case Management Legal/Non-Compliance visits will continue through January 2025.

No deficiencies cited during the visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/08/2024
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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