<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621220
Report Date: 08/23/2019
Date Signed: 08/23/2019 10:29:49 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:KING'S CHILDREN'S ACADEMYFACILITY NUMBER:
343621220
ADMINISTRATOR:KING, JOSETTEFACILITY TYPE:
830
ADDRESS:2635 EDISON AVENUETELEPHONE:
(916) 993-6510
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:6CENSUS: 0DATE:
08/23/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Josette KingTIME COMPLETED:
10:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Seychelle De Luca and Licensing Program Manager (LPM) Roxana Saravia met with Director Josette King for a proof of correction inspection to verify correction for the two Type B citations regarding the cleanliness of the carpets and missing staff's transcripts that were cited on 7/24/2019. All individuals subject to criminal background review have obtained a criminal record clearance. On 7/25/2019, Director emailed LPA staff's transcripts. During today's inspection, LPA and LPM obtained a copy of the receipt for the carpet cleaning.

LPA and LPM created a POC letter, clearing the deficiencies. LPA provided a copy to Director.

There were no deficiencies during today's inspection. A Notice of Site of Visit was provided and an exit interview was conducted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1