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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 090308259
Report Date: 12/01/2021
Date Signed: 12/01/2021 11:31:32 AM

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:HAPPY KIDS PRESCHOOL AND DAY CARE - COLOMAFACILITY NUMBER:
090308259
ADMINISTRATOR:YVONNE BEALFACILITY TYPE:
850
ADDRESS:2786 COLOMA STREETTELEPHONE:
(530) 626-0344
CITY:PLACERVILLESTATE: CAZIP CODE:
95667
CAPACITY:30CENSUS: 13DATE:
12/01/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Yvonne BealTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Amanda Blesi arrived at the facility and met with director, Yvonne Beal to conduct a case management inspection to amend the citation page, LIC 9099-D, Licensing report dated 11.08.21. The citation of General Sanitation: 101638.1 (e)(1) was corrected to Building and Grounds 101238(a).

There were three staff supervising 13 day care children. The director and the cook Alex were also present in the facility. Director provided proof of correction for deficiency previously cited. All citations are cleared at this time.

No deficiencies cited today.
Notice of site visit provided.
Exit interview with director, Yvonne Beal.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021
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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