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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009829
Report Date: 03/30/2022
Date Signed: 03/30/2022 11:27:02 AM

Document Has Been Signed on 03/30/2022 11:27 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:SUTLIFF, JESSICA FCCHFACILITY NUMBER:
483009829
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
03/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Jessica SutliffTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Glenn Ouye met with licensee Jessica Sutliff to conduct a capacity increase changing her small family child care home to a large family child care home. The application for the capacity change was received on February 11, 2022. The approved fire clearance was received from the Suisun City Fire Department on March 21, 2022.

LPA Ouye observed a fully charged fire extinguisher rated at least at 2A10BC and tested the functioning carbon monoxide detector and smoke detector. The licensee also conduct emergency disaster drill at least once every six months but tests the pull station fire alarm once a month.

The facility meets the requirements to operate as a large family child care home and is licensed as a large family child care home effective March 30, 2022.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2022
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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