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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340311129
Report Date: 08/20/2019
Date Signed: 08/20/2019 02:41:38 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:YMCA OF SUPERIOR CALIFORNIA- CDC PRESCHOOLFACILITY NUMBER:
340311129
ADMINISTRATOR:FUGATE, NANCYFACILITY TYPE:
850
ADDRESS:2021 W STREETTELEPHONE:
(916) 452-9622
CITY:SACRAMENTOSTATE: CAZIP CODE:
95818
CAPACITY:61CENSUS: 0DATE:
08/20/2019
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Nancy FugateTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Manager (LPM) Bettina Engelman and Licensing Program Analyst (LPA) Kristal Goodell met with Director Nancy Fugate for an Informal Office Visit.

LPM defined the difference between a non-compliance conference and an informal meeting. LPM advised that the purpose of today's meeting is to help the licensee gain compliance.
Today's informal meeting is to discuss Care and Supervision and self-reported incident that occurred on 3/13/19.

The following is the plan that was developed during the informal meeting.

1. A staff meeting was conducted the week after the 3/28/19 Licensing Inspection.

2. Parents were notified with a letter.

3. The Name-to-Face protocol has been revised, signed off and submitted to director daily.

4. Director has increased staff monitoring in all classrooms.

During today's meeting, LPM suggested that the director review the Department web site www.ccld.ca.gov for updated regulations and important information regarding licensing. LPM also provided information on the Child Care Licensing Advocates and the Department's Self-Assessment Guide for child care centers and suggested that director and facility staff can view information videos at www.ccld.childcarevideos.org
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal GoodellTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019
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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