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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009424
Report Date: 07/02/2024
Date Signed: 07/02/2024 09:16:57 AM

Document Has Been Signed on 07/02/2024 09:16 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:GRAY-MCDANIELS, CARLA FCCHFACILITY NUMBER:
483009424
ADMINISTRATOR/
DIRECTOR:		CARLA GRAY-MCDANIELSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 425-4057
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/02/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:59 AM
MET WITH:Prior Licensee Carla Gray-McDanielsTIME VISIT/
INSPECTION COMPLETED:
09:20 AM
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Licensing Program Analysts ( LPAs) Melchsiedeck Augustin and Elpidia Hernandez Torres arrived to the facility to confirm there were no children in care and to review the decision and order that went into effect on May 30th 2024. In which it states the prior licensee’s license to operate a family child care home is revoked and they are excluded from any licensed facility, and shall not have contact with clients of a licensed facility. LPAs toured the facility and observed there were no children in care.

LPAs reviewed the decision and order with prior licensee and issued a copy of the documentation. Prior posting of the Temporary Suspension Order ( TSO) has been taken down, LPA collected the prior License issued. This facility is permanently closed per the department.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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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