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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343614793
Report Date: 10/12/2023
Date Signed: 10/12/2023 09:54:10 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/12/2023 09:54 AM - 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:WILLIAM DAYLORFACILITY NUMBER:
343614793
ADMINISTRATOR:MARTENS, TOMFACILITY TYPE:
850
ADDRESS:6131 ORANGE AVENUETELEPHONE:
(916) 427-2637
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:24CENSUS: 0DATE:
10/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Krisean StewartTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the school representative, Krisean Stewart, for annual inspection. Purpose of the inspection was explained. During today's inspection, no preschool children were present.

During the inspection, the school representative informed that the school is not and will not be operating the child care in room 5 for this school year. It is uncertain at this time about resuming the child care. LPA informed the school that an inspection will be conducted when the school resume the care.

Copy of this report was reviewed and provided to the facility representative. Notice of site visit was 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: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2023
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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