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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618875
Report Date: 05/16/2019
Date Signed: 05/16/2019 12:48:24 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:ROGERS, KANIKAFACILITY NUMBER:
343618875
ADMINISTRATOR:ROGERS, KANIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 927-2219
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY:14CENSUS: 9DATE:
05/16/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Kanika Rogers, LicenseeTIME COMPLETED:
01:00 PM
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Licensing Program Analysts (LPAs) Joleen Kenney and Rosie Pitts conducted a case management inspection and met with the Licensee Kanika Rogers. The purpose of today's inspection was to follow up on the deficiencies that were previously cited on 2/28/2019 and 4/25/2019 and verify that the Licensee is operating within capacity as required in Title 22 regulations. LPAs observed the Licensee was in compliance during the inspection with the Licensee, one Assistant and 9 children present in the day-care home. The deficiencies that were previously cited were cleared at the time of this inspection.

No deficiencies were observed and cited during today's inspection. An exit interview was conducted and a Notice of Site visit was provided and posted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Joleen KenneyTELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2019
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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