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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620238
Report Date: 10/19/2023
Date Signed: 10/19/2023 02:27:49 PM


Document Has Been Signed on 10/19/2023 02:27 PM - 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:HANSEN'S EARLY LEARNING CENTERFACILITY NUMBER:
343620238
ADMINISTRATOR:HENSLEY, RHONDAFACILITY TYPE:
840
ADDRESS:5275 TEGAN ROADTELEPHONE:
(916) 684-1600
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:28CENSUS: 9DATE:
10/19/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Rhonda HensleyTIME COMPLETED:
03:00 PM
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On 10/19/2023, Licensing Program Analyst Katy Velazquez (LPA) conducted a field visit to the facility for the purpose of a case management inspection regarding a Plan of Correction. LPA arrived at the facility and was met by Director Rhonda Hensley (D1). LPA disclosed the purpose of the inspection and was granted entrance into the facility. LPA determined through accessing Guardian that all required adults were background cleared and associated to the license.

LPA conducted staff file reviews on 10/19/2023. LPA observed that the files were not complete and were missing proof of immunizations for current staff members. LPA cannot clear the Plan of Correction from 09/14/2023. As a result of the failure to complete the Plan of Correction, a Civil Penalty was assessed on 10/19/2023. LPA will conduct an unannounced POC visit to clear the deficiency.

An exit interview was conducted, and the report was reviewed with D1. 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: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2023
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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