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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343614231
Report Date: 09/10/2020
Date Signed: 09/11/2020 10:02:01 AM

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:CHILDREN'S FIRST LEARNING CENTERFACILITY NUMBER:
343614231
ADMINISTRATOR:AMEY, NYMIAFACILITY TYPE:
850
ADDRESS:3039 KILGORE ROADTELEPHONE:
(916) 852-2505
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY:42CENSUS: 13DATE:
09/10/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Nymia AmeyTIME COMPLETED:
01:30 PM
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On Thursday, 9/10/20 at 12:30pm, Licensing Program Analyst (LPA), Jan Hoshida, met with Director, Nymia Amey, via Zoom due to COVID-19 pandemic, for the purpose of a case management inspectin to discuss the unusual incident report (UIR) that the program submitted on 9/3/20. There were 13 napping children supervised by two staff.

LPA conducted interviews and conducted a health and safety inspection of the classroom.

No deficiencies were cited in today’s visit.

Exit interview and Notice of Site Visit was posted.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2020
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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