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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620846
Report Date: 01/21/2020
Date Signed: 01/21/2020 09:53:38 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:HARRIS, SONYAFACILITY NUMBER:
343620846
ADMINISTRATOR:HARRIS, SONYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 640-7776
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:14CENSUS: 3DATE:
01/21/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Sonya Harris, LicenseeTIME COMPLETED:
10:10 AM
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Licensing Program Analyst (LPAs) Joleen Kenney conducted an unannounced plan of correction visit and met with the Licensee Sonya Harris. The purpose of the visit was to clear the deficiencies that were cited during the visit conducted on 12/13/2019.

LPA reviewed some children's files during the inspection and it was observed that the children's files had the required documents. LPA Kenney was provided proof of enrollment for an updated CPR and Pediatric First Aid training on January 25, 2020 for the Licensee, Licensee's spouse and the Licensee's adult child. The citations were cleared during today's inspection.

An exit interview was conducted and a Notice of Site was provided and posted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Joleen KenneyTELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020
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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