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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313608538
Report Date: 11/23/2021
Date Signed: 11/23/2021 04:49:14 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: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: 11DATE:
11/23/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Bernadette AdeTIME COMPLETED:
03:30 PM
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At 2:20 p.m. on Tuesday, November 23rd, 2021, Licensing Program Analysts (LPAs) Karyn Guerra and Josiah Gathing met with Licensee, Bernadette Ade, for the purpose of a case management-incident inspection. A risk assessment for COVID-19 was conducted prior to entry into the facility. Census consisted of 4 school age children supervised by 1 staff, and 7 napping preschool children supervised by 1 staff. The purpose of today's inspection was to follow up on a self reported incident received by the department on November 10th, 2021. During today's inspection, LPAs conducted interviews, requested documents, and made observations.

No title 22 deficiencies were cited during inspection. An exit interview was conducted and a notice of site visit provided.Notice of site visit shall remain posted for 30 days.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021
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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