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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340314892
Report Date: 03/25/2021
Date Signed: 03/25/2021 01:15:15 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:GENERAL DAVIE, JR. PRIMARY CENTERFACILITY NUMBER:
340314892
ADMINISTRATOR:ANDREWS,J/MARRIOTT,LFACILITY TYPE:
850
ADDRESS:1500 DOM WAYTELEPHONE:
(916) 971-7375
CITY:SACRAMENTOSTATE: CAZIP CODE:
95864
CAPACITY:248CENSUS: 0DATE:
03/25/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Nadia KerseyTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Christopher Bello met with Education Content Specialist, Nadia Kersey, for a Case Management Licensee Initiated inspection using the FaceTime application. Today’s inspection regarded a capacity increase from 216 preschool children to 264 preschool children including 32 Toddlers ages 18 – 30 months in rooms 4 and 5 under a toddler option program for a total for 296 children. LPA took a tour of the facility and rooms 12 and 18 which were being added for facility use. The facility has an adequate number of sinks and toilets and urinals to accommodate 296 children. At time of inspection the facility had no deficiencies and was incompliance with Title 22 regulations and the Health and safety code.

ROOM MEASUREMENTS:
Room 12: 29 ft x 46.8 ft = 1357 square ft.
Room 18: 29 ft x 28.83 ft = 836 square ft.

Effective 3/25/2021, approved for 216 preschool children ages two years old to entry into first grade in rooms 1, 2, 3, 14, 15, 16, 17, 19, 20 and 21, additional 48 preschool children ages three to five in rooms 12 and 18 and 32 Toddlers ages 18 – 30 months in rooms 4 and 5 under a toddler option program for a total for 296 children.


No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the director and provided copies via email. An exit interview was conducted. LPA emailed Notice of Site Visit posted and the director understands it must remain posted for 30 days. The director will send an email back stating that they received the documents to act as their virtual signature.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2021
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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