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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623319
Report Date: 01/06/2022
Date Signed: 01/06/2022 01:27:45 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:LILY PAD EARLY LEARNING CENTER, INC.FACILITY NUMBER:
313623319
ADMINISTRATOR:ZEMLICKA, MICHELLEFACILITY TYPE:
830
ADDRESS:1388 LINCOLN WAYTELEPHONE:
(530) 863-9443
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:19CENSUS: 11DATE:
01/06/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Michelle Zemlicka - DirectorTIME COMPLETED:
01:45 PM
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On Thursday, January 6th, 2022, at 11:55am, Licensing Program Analyst (LPA) Blake Morillas conducted a Plan of Correction inspection on the facility's Preschool program in regards to a citation that was issued on 12-6-2021. Upon arrival, the Director, Michelle Zemlicka, was informed of the reason for the visit. 11 infants and 3 staff were observed in the Infant room of the facility.

When conducting the inspection of the Preschool Program, LPA observed that the Infant staff were not wearing face covering while inside the classroom. This observation was brought to the attention of the Director who stated that they have been supplied with face shields and disposable mask. The Director then reminded the staff to wear said face coverings. When later visiting the classroom, the infant staff were observed to be wearing their face shields

Even though the area of concern was addressed and dealt with, a Technical Assistance note (LIC 9102) was given to the Director in regards to current Masking guidelines and Covid-19 protocols.

No deficiencies were cited during today's inspection.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Michelle Zemlicka.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake MorillasTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
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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