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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619021
Report Date: 12/11/2019
Date Signed: 12/11/2019 12:11:32 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:QUINONES, MARIAFACILITY NUMBER:
343619021
ADMINISTRATOR:QUINONES, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 804-8400
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY:14CENSUS: DATE:
12/11/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Maria QuinonesTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Goodell met with licensee, Maria Quinones, for the purpose of a Plan of Correction inspection regarding deficiencies cited on 11/7/19. During today's inspection LPA observed 4 children present with licensee and assistant. All individuals have obtained fingerprint clearance.

On 117/19, licensee was cited due to at least 7 incomplete children files. During today's inspection LPA observed children's files are complete therefore deficiency cleared.

On 11/7/19, licensee was cited due to licensee's proof of immunization for measles and pertussis was not available to review during Annual Inspection. During today's inspection, LPA observed documentation, therefore deficiency cleared.

No deficiencies cited. Report was reviewed and discussed with licensee. Notice of Site Visit issued and must remain posted for 30 days.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal GoodellTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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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