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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623344
Report Date: 09/15/2022
Date Signed: 09/15/2022 03:17:59 PM

Document Has Been Signed on 09/15/2022 03:17 PM - 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:MARK, LATYESEFACILITY NUMBER:
343623344
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
09/15/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Latyese MarkTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the licensee, Latyese Mark, for a case management inspection. The licensee has applied for capacity increase from eight to 14 children in care.

After receiving the licensee's application, Licensing department requested the fire inspection to be conducted at the property. An approved fire inspection document was received on September 13, 2022. During today's inspection, LPA inspected the home. The house has smoke alarm, carbon monoxide detector and fire extinguisher on site. LPA also discussed the capacity and ratio requirements with the licensee and informed that anytime, licensee operates as large license, licensee must have another helper. LPA reminded the licensee that all adults, 18 years and older living in the home, helper or assistant must have criminal record clearance and must be associated to the facility prior to having any contact with children in care. Failure to do so could result in an immediate civil penalty of $100.00 each day. Licensee has CPR training certificate valid until December 2023 and Mandated reporter training certificate valid until December 16, 2023.

As of today, licensee meets the requirements of a large family child care home and license will be granted. Copy of this report is reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2022
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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