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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340306386
Report Date: 07/09/2019
Date Signed: 07/09/2019 11:14:23 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:OAK PARK PRESCHOOLFACILITY NUMBER:
340306386
ADMINISTRATOR:ARCY, CURRIEFACILITY TYPE:
850
ADDRESS:3500 2ND AVENUETELEPHONE:
(916) 451-9498
CITY:SACRAMENTOSTATE: CAZIP CODE:
95817
CAPACITY:34CENSUS: 12DATE:
07/09/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Pamela MorganTIME COMPLETED:
11:45 AM
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Licensing Program Analysts (LPAs) Seychelle De Luca and Marissa Soto met with Director Pamela Morgan for an unannounced case management inspection to discuss the Unusual Incident Report (UIR) that the program called in on 7/1/2019 and submitted on 7/2/2019 and which occurred on 6/20/2019. Upon arrival, LPAs observed 12 children in care and four staff members. During today's inspection, LPAs interviewed staff and children.

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: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2019
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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