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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093617580
Report Date: 09/18/2019
Date Signed: 09/18/2019 02:37:38 PM

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:PRAISELAND ACADEMY OF EL DORADO HILLS (PS)FACILITY NUMBER:
093617580
ADMINISTRATOR:HESTER, LISA JANELLFACILITY TYPE:
850
ADDRESS:5003 WINDPLAY, SUITE 3TELEPHONE:
(530) 781-3556
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY:97CENSUS: 79DATE:
09/18/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lisa HesterTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Marea Behvand and Seychelle De Luca met with Director Lisa Hester for an unannounced case management inspection to discuss the unusual incident report (UIR) that the program submitted on 09/12/2019 and which occurred on 09/10/2019. LPAs interviewed staff and parent.

In the areas that were evaluated, no deficiencies were observed at the time of the visit. An exit interview was conducted and a Notice of Site Visit was posted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea BehvandTELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2019
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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