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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623107
Report Date: 12/10/2021
Date Signed: 12/10/2021 09:49:02 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:YOUNG EXPLORERS (INF)FACILITY NUMBER:
343623107
ADMINISTRATOR:OCHOA, DEBORAHFACILITY TYPE:
830
ADDRESS:8065 ELK GROVE FLORIN RD, #150TELEPHONE:
(408) 306-3795
CITY:SACRAMENTOSTATE: CAZIP CODE:
95829
CAPACITY:12CENSUS: 2DATE:
12/10/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kiara PendarvisTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 9:00am and met with Teacher Kiara Pendarvis for a Case Management inspection. The inspection regarding clearing citations cited on 11/19/21 (See LIC809D’s dated 11/19/21). LPA observed that the children were not comingled and one staff member with current CPR certification. LPA cleared the deficiencies and provided the clearance letters.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the director and provided copies. An exist interview was conducted. LPA observed the Notice of Site Visit posted and the director understands it must remain posted for 30 days.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021
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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