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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500090
Report Date: 10/04/2023
Date Signed: 10/04/2023 10:48:40 AM

Document Has Been Signed on 10/04/2023 10:48 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:GORHAM, MEGHANFACILITY NUMBER:
574500090
ADMINISTRATOR:GORHAM, MEGHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 721-7198
CITY:WEST SACRAMENTOSTATE: CAZIP CODE:
95691
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
10/04/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Meghan GorhamTIME COMPLETED:
11:05 AM
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Licensing Program Analyst (LPA) Erwin Tjhia and Licensing Program Manager (LPM) Bettina Engelman conducted unannounced visit to the facility to take additional measurements of the pool area. There were 10 children present during today inspection and one assistant.

The pool area is separated from the backyard by 5 foot meshed fence that extends from the corner of the home to the left of the patio door to the wooden perimeter fence. There are five windows leading from the back of the house to the pool area, and 5 windows leading from the side of the house to the pool area. Each set of windows has one window that doesn't open. The shortest distance from the home to the pool area are 5 feet 7 inches.

Licensing staff advised the licensee that additional fencing needed to be installed to prevent access to the pool. The fencing shall be attached to the existing fencing to left of the gate, along the back of the home to the wooden perimeter fence.

Licensee stated that she would like to explore with licensing staff the option of exchanging the eight windows with those that can not open. Licensing staff reminded licensee of her responsibility to abide by Title 22 regulations and to ensure supervision. Further follow-up and a return inspection are needed.

Exit interview was conducted and report was reviewed with Licensee, Meghan Gorham. A notice of site visit was provided and posted by LPA and must remain posted for 30 days.

No Title 22 deficiencies observed in the areas evaluated during the inspection.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2023
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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