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Home My WebLink AboutAdministrative Permit APX2007018 - PlansSTATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY SKETCH (Floor Plan)0000 • Applicants are required to provide a sketch of the floor plan of the home or facility and outside yard. The floor sketch must label rooms such as the kitchen, bath, living room, etc. Circle the names of the rooms that will be used by staff/re9qMs2'clients' itcfr*n. Door and.000 window exits from the rooms must be shown in case of an emergency (see Emergency Disaster PISA). • Show room saes (e.g. 8.5 x 12 . Kee close to'scale. Use the s ace below. See back for and sketch. • • • • • • 0 • •o••ooFOfll m ADDRESS: (il U-.V`r _ 5I -t OV\ C4'• of Z(cq(l 0 0 000 00 0 009000 0 TI I_ . _ I ( I 1 9 9 9•i- ®-®--1---) 1T(_I T T L L I_I_ ! I _I I I9°'I! -tI -f---,1i1 l l 1 1 T I ! I (_ -9 0 L.-ILL 1 -I! 1 T IIEII %Iv1!-I G} ( '7 T i _ i_ 1 1_ ! !! >_ 1- 17- r ' ! 1 1 __j--L _ l i i i j_ I T IT o Z-Ii !TLI iII r__I T IL I I-! I_;Ip IT _r! _ !_-Z i I T--I TI ! I T to I I! TT- I 1 T!!I_i L col FI' -' I i ,. I_ !' I I I I T I I _I I t ! I' I I- 1 I! I J.wt •_a: AT end o I LL_ I r I ' I fI I _ I I _i ! ! 1 I I I-i i I -i fT_I- _ TI I -'-1- T i I I I L-4'-L _ I ! 1 1._L t _- 1 t _•--1 '_- -__ ! ! I .-'t-..--J.-1--._ L_-ii_-•--, r_i ,- fi ; -f -ter !_ _L1 I I{± _Lawf 1 W evio ! t 4_ I A-_L -A i -.-;1 I,I II-I t-I'- I i- . ____-_ _I LLI L T---J_._ 1 ! I- !1 T-I I--I -*-l T-: I ! 1i ( T(l i ! -T I fi_ ''_ n! __ i---._T.: 1. .:.-- -..- _:- __ _L-_'- '-;'-1 -' -- ----•-- --! - --i L G +- - -- '-- -ti_ i Lam' + 1 I"US_ L- I __._ t`i -r1--;-_:I A 4-.L_ -+ -aw?'L F-t CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING 999 (399) STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENC 0 CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING FACILITY SKETCH (Yard) The yard sketch should show all buildings in the yard including the home (with no detail), garage and•storaoe building. .Include walks, driveways, play area, fences, gates. Show any potential hazardous area sucb,3Apools,;gprbee storage, animal pens, etc. Show the overall yard size. Try to keep the sizes close to scale. Use the.sp 'below.o 0 0 0 FACILITY NAME: I LT i I i ! ( _ t I rT - !- ADDRESS: 0 ••Cam' V4L • tr•cJ ,•u c • o ® L_L 11 I. I- ! ti . 11' "; I! I I I I 11 1I1 00 0 0 000 000 • 0 I r l I I I I I f !I o0 1 1 _ I ! _ ! _Y T - I I ' I i _ ' LI I l- 1 ! I I 1 L I I I _IL I -I L_ ! II I I !--1--} ;1-I -L ! -I -T \L FT. L 1 _! - I _ I I__L__I, I! I fY I I I I I I j I h!--+-r-!L - f -!T ! ! 7 I _ Ck -D ---} -Tll-I I ! I - I I III !' I T.I T-_ I _ I _ I I I C `; !-}- C- I-I IL +fi I j r-f-, (_I I o + TT ! I I I I! I I N II III II I Ili T I I L_ LPL I -- I ! i I i I I I I f' I I ! I_L ! I P! I +1 I_ 1__ i_ l+ tiL I _-I -!}T'L -T- 74 L _ I _I ! L 1 I i i L^H I I ! - -- - -T 5T -44L Li j LL I- i L L '_ . _ t r -J- - -rt_-I -`I'- I I• '-----I- +_-' '--Li . _i-t_ .._ __ ' ' 'f-f -t.._,_ 1 .-r - T i f r r -r __E -i I r r -I T r 1 1 l_ L 1 a 'A l _r_.}r C-.GAT t rfi -T o 0 17 T T ' L oII J 11 1 I I I 1, I -I STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENO CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING FACILITY SKETCH (Floor Plan) r _I -L -,. I- I 0000 Applicants are required to provide a sketch of the floor plan of the home or facility and outside yard. The floor sketch must label rooms such as the kitchen, bath, living room, etc. Circle the names of the rooms that will be used by staff/reSiaoMtSrclientsl2hildoen. Door and window exits from the rooms must be shown in case of an emergency (see Emergency Disaster P146). 'show room sizes (e.g. 8.5 x 12 . Kee close to scale. Use the s ace below. See back for and sketch. ''e• ° • U FACILITY ADDRESS: • •0 0.00rr• kv s I t ta%Gs e a ZCa • ! 1 I! I I! ! I I I -F -1-FT-I- _T __` I IIII ,_ I I( III !! I! --pB( ]Yl rj r 7 ,L 4 I I J I c • I I_ L I 000000 I 0000 I I I 0 0 Is i ' I iT-i I - II I I Itl I I I I _ II I _I I ' ! I_I I I I 1 k keth,Q 0_ U"Ix U SLII - r r --- } 1 (. I--j-I _I {I 1! l_ i 1 T? _1,p I _ t !- - -L 1T r -T r -f T *-i - - F 1 ! I I- F- '! - I I r! I I!I! -- i T j!I _L _I H t°- ICI ! -l1 0000 • 0 000 00 0 ! i i I I I I I_ 1± -!f I YV i'A! !IT 7 T1* T r! iyv;.±ilasy I ! !yyvdo I- I I 11 C I I I }l T_I +!i,I 1 -i I I -ILI 4,! I I ! I L' _II_ I _; ! I! I i I Lei ! _ I F- Lj_I I I I I! ! 1 j I T_ I H 1! 11 I I!T T-1 71F I_ Li I I I IJ _ _L `r i f-li T !r-t- _LJ !! - -T L I f-I ! I! I j !.+I I iW I a I r !_ ! f I IIT 74 -1 l l-L _ _.-_-.-•- - - -lr----j----- - r-{- -t- f +--- -- -h -' S- _-! _ I _i! Ti Lr i. 1- _ -f f-I T - - I , ; `1 -,t I 1 1 I 1 ' I I ! I QDD-; -!-f- I t I hr I I I 1 ! I , +ri 4 laic L t- LIC 999 (399) STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENC%0 . CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING FACILITY SKETCH (Yard) ,The yard sketch should show all buildings in the yard including the home (with no detail), garage and°storat a building. Include walks, driveways, play area, fences, gates. Show any potential hazardous area sucp.agpools,:gar+tfarge storage, animal pens, etc. Show the overall yard size. Try to keep the sizes close to scale. Use the,sjfa below •° O FACIUTY NAME. ADDRESS. I • • . • 00 00 °0 ° ° ° ° 0 0 °O 00 _I L ,,0- ®T- ! ' I I! _I ° o o I!!! I )1- ;- --+-- --++- iT- L_-__'- -C-r ;C y I - - rt 1-Ii I _I_ C _ I T I4T t_J_- i I I_ L l _ I r I-I ( L 2 `f'-T i r I I I! ,-(I rT I '!rtei r I '' ET, i C _ f L I [I.•_ I r_= ! I I I { _ -J-) I- +- --I I ICI I I ! I__ !k L-L L L-; Li T1 'I I 11 rI T I I f l ±-F I'-Hi---I - -r-r - ? 7 -I L4-7 f j 7-I -T LL I r f tf r I I I 4-1 1 cl t 7 7 -- r -- - }- _a - 1 L -r 437 -AT1 I I t- ~,•N Q t-- -- r t 1_ STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES A 0 CALIFORNIA DEPARTMENT OF SOCIAL SERVICESCOMMUNITY CARE LICENSING FACILITY SKETCH (Floor Plan)9000 Applicants are required to provide a sketch of the floor plan of the home or facility and outside yard. The floor sketch rp11st label rooms such as the kitchen, bath, living room, etc. Circle the names of the rooms that will be used by staff/residhNclientd/gdijcijen. Door and window exits from the rooms must be shown in case of an emergency (see Emergency Disaster PlaA).0thow room Sizes (e.g. 8.5 x 12. Kee close to scale. Use the s ace below. See back for and sketch. : °:''; ew`v, ,TV Afll FMS. U • •. 0 V Si -6 C C V° L a it1+ 1 H T -T -TI- , I ILT I ! F- I ! r f, FRI_T i I I' I I I1Z I I lilt 1,2 ..-._, !r_'! _! i I J ! ! 1_! I ILI !L !'L ! I I ! ! ! ! 1 ! I j- '' Ll !IIII____ !! I II !1 T!III F! fi 1 - f - i - L! 0 0 - (,nri aNl '!A;1_1nd eW_ LrI -I- l i i+r r I _f i I ! F_ _ - L_l_ I i-I -I I I !{ I I`' ' 'tI_-L_i-I_ I I 4 7,11-- L i L ! I;- -l rat _I i ! + T T r -+I r ! - ! } ewe4-4--TT ! `I- - r w vi I ! W IV oM /^1-,i ! I 1 iI _ I I 1I ; 71 All J-i ± 7 JL I `Tl ` i?t {1 4- L:_ly i NYvtL`"4 L i- t -I L + + j 7 f L -T. ! _ - i_ ! T_ rV± I1PJ t BtJI._- I 0-1"'rLL }'`_.- ..-- --f--.--j -----'bn I I I I pbo • 7'. 7 h.Q k r aft C 0 o..o 1r999 I ,, LIC 999 (3,99) STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGEN•• CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING FACILITY SKETCH (Yard) The yard sketch should show all buildings in the yard including the home (with no detail), garage and•skwabe building. Include walks, driveways, play area, fences, gates. Show any potential hazardous area sucb.a pools,°g§rbq a storage, animal pens, etc. Show the overall yard size. Try to keep the sizes close to scale. Use the.a aae below' ° ° ° O FACILITY NAME.ADDRESS: 4S la- s • . • • 00• • O 0 0. 0p• 0 • 0 o ! T I Tr ! I f! ! T ri I I! !TI i! ( ! T I _' T I _L I I_ I __ I. I I_'j I_ I I T`i !! ^T L -Lj-111 411I- ! _ I!I I ! ! ' I ! _' ' _ k ) t_ I !!, , ! fi I4` ! I I I i i t I T I I ! !iID,- T T -I_ I I I!,! f i 1- ITI I !!-=;-el! ! T- _ _1-!-Il! _L__ T-I I I T T -1 I _ _ ! I 7 1 i I I i t I _! i T Z ! r I T !! 1 I -T-0 I I 11 I T I _IL -1 !--{-I- -1-I !--h 1 I f ! T T! TI I I I I- ! 1 IT^ I! I I i o I I i! l i L I I I! i t l I - L^jl I I I T - -L CI I I +LI T !I 4-4-4- 1 1 1 -14-41 -! JP IJ Tfi _' - - (II T L -I-T T t- ! ! I If yt I 1 I I + I -r 'L1 L f- ! I I ;I---- II_r -I a- r !-: r-i t1 ICI i ICI I'T!jtI f I I! a! !1 f- - f F }_ j -!-L - J--t- i --!------fi-r ! I +- 4- i