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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313608538
Report Date: 06/11/2019
Date Signed: 06/11/2019 09:34:29 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:HUGS-N-SMILES PRESCHOOL AND DAYCAREFACILITY NUMBER:
313608538
ADMINISTRATOR:ADE, BERNADETTEFACILITY TYPE:
850
ADDRESS:1273 HIGH STREETTELEPHONE:
(530) 823-6385
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:30CENSUS: 18DATE:
06/11/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Bernadette Ade - DirectorTIME COMPLETED:
09:45 AM
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Licensing Program Analyst (LPA) Blake Morillas conducted a unannounced Case Management visit in regards to a received, self reported, Unusual Incident Report (UIR) of an incident that occurred on 5-14-2019.
LPA informed the Director, Bernadette Ade, of the reason for the inspection. Upon arrival there were 7 Preschool children and 11 School Age children present along with 2 staff.

LPA toured the day care facility where the incident occurred and conducted interviews of the relevant parties in regards to the incident, after which it was determined that no Title 22 violations took place.

Report was reviewed with the Director and an exit interview was conducted.

Notice of site visit posted.

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake MorillasTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2019
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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