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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093615992
Report Date: 12/06/2019
Date Signed: 12/06/2019 10:05:55 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:FROGGIE FRONTIERFACILITY NUMBER:
093615992
ADMINISTRATOR:NAGARAJAN, SUDHANYAFACILITY TYPE:
850
ADDRESS:1001 OLSON LANETELEPHONE:
(916) 933-3714
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY:36CENSUS: 32DATE:
12/06/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Joelle GoebelTIME COMPLETED:
10:15 AM
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Licensing Program Analysts (LPAs) Michelle Pascual and Tanya Washington conducted an unannounced case management inspection in order to confirm the removal of staff member Kaitlyn Basker. LPAs met with the owner Joelle Goebel who stated that Kaitlyn Basker never began working in the center as they were awaiting clearance approval beforehand.

Based on evidence obtained during today’s visit, the LPAs have verified the individual is not present or employed at the facility. LPAs noted that all staff present during today's inspection are fingerprint cleared and associated to the facility.

LPAs provided Ms. Goebel with LIC500 Personnel Report, she stated that she will update it and fax to LPA Pascual.

No deficiencies are cited during the inspection. Notice of site visit posted.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2019
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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