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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009866
Report Date: 02/14/2025
Date Signed: 02/14/2025 11:10:26 AM

Document Has Been Signed on 02/14/2025 11:10 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/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
02/14/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Miranda MoffettTIME VISIT/
INSPECTION COMPLETED:
11:30 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
Licensing Program Analyst (LPA) Glenn Ouye arrived unannounced and met with licensee Miranda Moffett to conduct a capacity increase case management visit. The application for the capacity increase was received on January 9, 2025. The approved fire clearance was received on February 10, 2025.

There are functioning smoke and carbon monoxide detectors and a fire extinguisher rated at 2A10BC. The pull station fire alarm is located near the front door. The last fire drill that the licensee conducted was on February 10, 2025 when the fire inspector tested the pull station fire alarm.

LPA Ouye and licensee Miranda Moffett discussed the small and large staff to child ratio requirement. LPA Ouye also provided the licensee a handout regarding the requirements.

The license is approved as a large family child care home to care for up to 14 children. The license will be sent to the licensee.

No deficiencies cited during the visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2025
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