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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340320714
Report Date: 01/28/2020
Date Signed: 01/28/2020 01:32:34 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:SACRAMENTO CITY COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
340320714
ADMINISTRATOR:GARCIA, LISAFACILITY TYPE:
850
ADDRESS:3835 FREEPORT BLVDTELEPHONE:
(916) 558-2542
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:65CENSUS: 28DATE:
01/28/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Laurie PerryTIME COMPLETED:
01:45 PM
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Licensing Program Analysts (LPAs) Mai Lor and Christopher Bello conducted an unannounced case management inspection and met with Director Laurie Perry. The purpose of this inspection is to confirm the removal of an adult individual by the name of Marcel Wilson. During this inspection, LPAs toured the interior and exterior of the facility with the director. Census included 28 children and eight staff. Based on evidenced obtained today, LPAs verified that Mr. Wilson is not present, employed, or residing at the facility. LPAs obtained a copy of confirmation of removal.

Notice of site visit was provided and posted. Exit interview conducted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
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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