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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619593
Report Date: 07/31/2020
Date Signed: 07/31/2020 10:28:51 AM

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:CYRIL SPINELLI CDCFACILITY NUMBER:
343619593
ADMINISTRATOR:MITCHELL, KRYSTLEFACILITY TYPE:
840
ADDRESS:3401 SCOTLAND DRIVETELEPHONE:
(916) 348-7415
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:56CENSUS: 0DATE:
07/31/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Krystle MitchellTIME COMPLETED:
10:30 AM
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LPA Kelly made an automated inspection at 9:30am due to COVID-19 emergency at the facility to conduct a Room Change review.

LPA viewed Room #3 which will be used for the school-age program. The room is furnished and included rugs, shelving, toys, art supplies, furniture, table and chairs. Children have access to restrooms.
Room #3 has a refrigerator, sink, counter and cabinet space, sinks with a drinking water fountain attached. Indoor and outdoor measurements were not required due to the site is located on Elementary School campus.

The school-age children and preschool children are never to be co-mingled while in care.

Rooms #2 and #3 will be used for the school-age program

Fire clearance has previously been granted for the room.


This Report was provided to licensee to be signed and be returned to LPA via email.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Socorro KellyTELEPHONE: (916)216-7792
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2020
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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