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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615376
Report Date: 11/23/2021
Date Signed: 11/23/2021 01:38:12 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:WEE TYMES PLAYSCHOOLFACILITY NUMBER:
343615376
ADMINISTRATOR:INGALLS, DANELLEFACILITY TYPE:
850
ADDRESS:2925 ROOT AVENUETELEPHONE:
(916) 487-8411
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:30CENSUS: 16DATE:
11/23/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:BrittTIME COMPLETED:
01:50 PM
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At 12:15 p.m. on Tuesday, November 23rd, 2021, Licensing Program Analysts (LPAs) Karyn Guerra and Josiah Gathing met with Staff, Brittney Stewart, for the purpose of a case management- incident inspection. A risk assessment for COVID-19 was conducted via telephone prior to entry into the facility. Census consisted of 12 school age children supervised by 2 staff, and 4 napping preschool children supervised by 2 staff. Today's inspection was to follow up regarding an incident that occurred on November 15th, 2021. Facility self reported the incident on November 19th, 2021. During today's inspection, LPA conducted interviews and requested documents.

No title 22 deficiencies were cited at this time. An exit interview was conducted and a notice of site visit provided. Notice of site visit shall remain posted for a period of 30 days.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021
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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