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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009879
Report Date: 05/06/2022
Date Signed: 05/06/2022 11:32:51 AM

Document Has Been Signed on 05/06/2022 11:32 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:MORGAN, LISA FCCHFACILITY NUMBER:
493009879
ADMINISTRATOR:MORGAN, LISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 861-2188
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 9DATE:
05/06/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:03 AM
MET WITH:Lisa MorganTIME COMPLETED:
11:19 AM
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A case management inspection visit was made to the facility by Licensing Program Analysts (LPAs) Y. Yang and S. Phouthavong at the request of the facility licensee to approve a previously designated "off-limits" for childcare use.

The licensee is requesting to use the "infant room" for childcare use. This room was previously designated as "off-limits" to children in care. LPAs inspected the room and approved it for child care use. The bathroom and the sink area in the "infant room" remain off limits and inaccessible by means of a child gate. "Bedroom A", which was previously listed as "on-limits" has been made off-limits at the request of the licensee. Licensee understands that off-limits areas shall be inaccessible to children in care at all times during childcare hours. There are no other changes. An updated floor sketch has been submitted to the Department.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Lisa Morgan.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2022
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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