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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621225
Report Date: 11/22/2019
Date Signed: 11/22/2019 09:21:56 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:OAK PARK PRESCHOOL INC. IIFACILITY NUMBER:
343621225
ADMINISTRATOR:CURRIE, ARCYFACILITY TYPE:
850
ADDRESS:4036 14TH AVENUETELEPHONE:
(916) 737-7322
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY:30CENSUS: 12DATE:
11/22/2019
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Sharon SimmonsTIME COMPLETED:
09:25 AM
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Licensing Program Analyst (LPA) Jeevun Birk-Miller conducted an unannounced collateral inspection and met with Sharon Simmons, Site Supervisor. The purpose of this visit was to interview a staff person in regards to a complaint #53-CC-20190909153500 unrelated to this facility. Sharon stated the staff person did not work at this facility.

At this time no citations were given and an exit interview was conducted.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun BirkTELEPHONE: (916) 263-1414
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019
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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