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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623552
Report Date: 09/22/2022
Date Signed: 09/23/2022 10:56:12 AM

Document Has Been Signed on 09/23/2022 10:56 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:FARFAN, LORINDAFACILITY NUMBER:
313623552
ADMINISTRATOR:FARFAN, LORINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 823-7311
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
09/22/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lorinda FarfanTIME COMPLETED:
11:15 AM
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On September 23, 2022 Licensing Program Analysts Lea Habtom and Katrina Owens met with licensee, Lorinda Farfan. The purpose of today's visit was to provide the licensee with an amended report for the complaint findings delivered on September 13, 2022. The census for today was 9 children with 3 infants and 6 preschool children being supervised by licensee and her assistant. Licensee was also provided with appeal rights.

An exit interview was conducted and a notice of site visit was provided.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2022
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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