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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340321700
Report Date: 09/23/2022
Date Signed: 09/23/2022 02:13:23 PM


Document Has Been Signed on 09/23/2022 02:13 PM - It Cannot Be Edited

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:SETA - FRUITRIDGE COMMUNITY CTR HEADSTARTFACILITY NUMBER:
340321700
ADMINISTRATOR:CARMEN SALCEDOFACILITY TYPE:
850
ADDRESS:5746 40TH STREETTELEPHONE:
(916) 563-5020
CITY:SACRAMENTOSTATE: CAZIP CODE:
95824
CAPACITY:40CENSUS: 0DATE:
09/23/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Carmen SalcedoTIME COMPLETED:
02:15 PM
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On Friday, September 23, 2022 at 2:00 PM, Licensing Program Analyst (LPA) Amanda Sutter met with Site Supervisor Carmen Salcedo for the purpose of an unannounced plan of correction inspection. There were no children present at the facility. All individuals subject to criminal background review have obtained a criminal record clearance.

Prior to inspection, Licensee Representative Betsy Uda emailed LPA photos of capped pipes for the faucets that tested above the Action Level Exceedance (ALE) for lead. During inspection, LPA observed these faucets were not operational and will clear the deficiency cited on 9/22/22 for deficiency WD 101700.3(b)(1).

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with site supervisor Carmen Salcedo.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Amanda SutterTELEPHONE: (916) 261-8918
LICENSING EVALUATOR SIGNATURE:
DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/23/2022
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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