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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615412
Report Date: 02/13/2024
Date Signed: 03/06/2024 10:21:19 AM


Document Has Been Signed on 03/06/2024 10:21 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:KIDZ COME FIRST CHILD DEVELOPMENTFACILITY NUMBER:
343615412
ADMINISTRATOR:WOOLSEY, ASHLYFACILITY TYPE:
840
ADDRESS:10374 TWIN CITIES ROADTELEPHONE:
(209) 744-2600
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY:28CENSUS: 0DATE:
02/13/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ashly WoolseyTIME COMPLETED:
12:00 PM
NARRATIVE
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On 02/13/2024, Licensing Program Analyst Katy Velazquez (LPA) conducted a field visit to the facility for the purpose of a case management inspection. LPA arrived at the facility and was met by Director Ashly Woolsey (D1). LPA disclosed the purpose of the inspection and was granted entrance. LPA toured the facility and observed 0 school aged children. LPA determined, through accessing Guardian, that all required adults were background cleared and associated to the license.

On 02/05/2023, D1 made the decision to close the entire facility for sanitization after the facility was exposed to a child with lice. D1 did not report this Unusual Incident to the Department. The lack of reporting poses/posed a risk to the health, safety, and personal rights of person(s) in care. As a result, a Type-B deficiency was cited on a subsequent 809-D page.

An exit interview was conducted, and the report was reviewed with Director Woolsey. LPA provided D1 with Licensee Appeal Rights. A Notice of Site visit was posted by LPA and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Katy VelazquezTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 03/06/2024 10:21 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: KIDZ COME FIRST CHILD DEVELOPMENT
FACILITY NUMBER: 343615412

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/20/2024
Section Cited
CCR
101212

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Reporting Requirements
(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours...
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D1 will watch “Child Care Reporting Requirements” on the CCLD website and report to LPA via email that she has done so by 5 PM on 02/20/2024. An LIC 624 Unusual Incident Report will be submitted via email to LPA by 5 PM on 02/20/2024.
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 a written report...(d)(2) below shall be submitted to the Department within seven days following the occurrence of such event...This requierment was not met as evidenced by an illness related closure on 02/05/2024 which was not reported to the Department.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Katy VelazquezTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2