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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573615117
Report Date: 06/08/2023
Date Signed: 06/08/2023 02:33:25 PM


Document Has Been Signed on 06/08/2023 02:33 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:PORTSIDE MONTESSORIFACILITY NUMBER:
573615117
ADMINISTRATOR:HERNANDEZ, M. SMITH, M.FACILITY TYPE:
850
ADDRESS:2700 LINDEN ROADTELEPHONE:
(916) 224-2033
CITY:WEST SACRAMENTOSTATE: CAZIP CODE:
95691
CAPACITY:84CENSUS: 73DATE:
06/08/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Rachel DelgadoTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Erwin Tjhia met with center Director, Rachel Delgado on 06/08/2023 for the purpose of an unannounced plan of correction inspection to clear a Type A deficiency, which was issued on 06/06/2023 for having an unfingerprinted adult at the facility.

There were 73 children including 21 toddler during today's inspection. LPA toured the facility and found no deficiency. All staff present during today visit were fingerprinted cleared and associated to the facility



Deficiency cited on 06/06/2023 is cleared effective today. Proof of correction letter was provided. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Erwin TjhiaTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2023
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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