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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340320714
Report Date: 08/19/2021
Date Signed: 08/19/2021 03:20:30 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:PERRY, LAURIEFACILITY TYPE:
850
ADDRESS:3835 FREEPORT BLVDTELEPHONE:
(916) 558-2542
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:65CENSUS: 0DATE:
08/19/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Laurie PerryTIME COMPLETED:
03:40 PM
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Licensing Program Analysts (LPAs) Christopher Bello and Mai Lor arrived at the facility for a Case Management Licensee Initiated Inspection at approximately 2:00pm. The purpose of the inspection was for a Health and Safety inspection of the facility prior to placing their license from Inactive to Active status. Upon arrival LPAs met with Program Director Laurie Perry and Interim Director Sadot Zarek and took a tour of the facility. Laurie stated that Room#3 will not be in use, LPA notified Laurie that before Room#3 is used for daycare purposes to notify the Department for a Health and Safety inspection for approval. LPAs notified Laurie that a Director packet needs to be submitted for the Interim Director. LPAs observed that the facility was in compliance with Title 22 regulations and The Health and Safety Code. LPAs approve the facility for use and places the facility back to Active status effective 8/19/2021.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
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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