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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313622152
Report Date: 02/12/2021
Date Signed: 02/16/2021 08:41:25 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:LITTLE SUNSHINE'S PLAYHOUSE & PS - GRANITE BAYFACILITY NUMBER:
313622152
ADMINISTRATOR:MARCI NEVESFACILITY TYPE:
830
ADDRESS:5370 DOUGLAS BLVDTELEPHONE:
(916) 605-0217
CITY:GRANITE BAYSTATE: CAZIP CODE:
95746
CAPACITY:48CENSUS: 15DATE:
02/12/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Marci PilgrimTIME COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Jeremey McClain met with Director Marci Pilgrim via Facetime Video for an unannounced Case Management Inspection. A Virtual Inspection was conducted due to Covid-19 requirements.

During the inspection LPA observed infant and toddler ratios which were: three infants supervised by four teachers in one infant room, six infants supervised by two teachers in another infant room, and six toddlers supervised by one teacher in the toddler room.

On 2/11/2021 LPA received an Unusual Incident Report via email. It was reported that on 2/10/2021 a child in care tripped and hit their head on the hinge of a door while playing in the classroom. The accident resulted in a cut above the child’s eye brow. The child was taken to the Emergency Room where their cut was glued together. The child returned to care the following day.

During the inspection LPA interviewed staff that witnessed the incident and observed the area where the incident happened. LPA determined that there weren’t violations of any Title 22 Regulations related to the incident.

LPA emailed a copy of this report the Licensee as well as a Notice of Site Visit, which should remain posted for 30 days
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2021
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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