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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343614113
Report Date: 06/15/2023
Date Signed: 06/15/2023 03:49:39 PM


Document Has Been Signed on 06/15/2023 03:49 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:SETA - PHOENIX PARK EARLY LEARNING CENTERFACILITY NUMBER:
343614113
ADMINISTRATOR:VANG, SHOUAFACILITY TYPE:
850
ADDRESS:4400 SHINING STAR DRIVETELEPHONE:
(916) 563-5075
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:55CENSUS: 26DATE:
06/15/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Shoua VangTIME COMPLETED:
03:00 PM
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Licensing Program Analysts (LPAs) Gagandeep Singh and K. Williams met with the director, Shoua Vang, for a case management inspection related to an incident. The facility self reported that there was an incident of a parent trying to get inside the facility, while not having the legal custody of the child. After being denied the access to the classroom, the parent was very upset and police was called.

During today's inspection, LPAs inspected the facility, interviewed the director and reviewed the documents. During the record review, it was found that father of a child has custody of the child and mother of the child attempted to get into the classroom. Per director, as facility staff stopped the mother of the child from getting inside the classroom, the mother became very upset and the facility had to call the local police department to help the situation. Per director, the child's mother never went inside the classroom. Per director, classroom doors were locked and there was no child in the play yard or front of the facility. Per director, police report was filled and the child's father is under the process of getting permanent restraining order against the mother of the child.

During today's inspection, LPAs did not observe any violation of any regulations. The facility followed the procedure of keeping the children safe. Copy of this report was reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:
DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2023
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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