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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624142
Report Date: 01/21/2022
Date Signed: 01/21/2022 10:39:34 AM

Document Has Been Signed on 01/21/2022 10:39 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:MCCLARA, XIAOPINGFACILITY NUMBER:
343624142
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
01/21/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Joy McClaraTIME COMPLETED:
10:45 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) Kelly Ferrara arrived at the home and met with applicant Joy McClara. LPA observed that the applicant lives in the home next door which is 5805 71st street. Applicant stated both homes were on the same deed. LPA contacted LPM Mayorga and advised applicant that further review would be needed in order to assess if the home could be licensed. The applicant provided a copy of the deed to the LPA. A subsequent review of property details is needed.

LPA gave applicant a copy of this report.
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2022
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