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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623044
Report Date: 03/10/2025
Date Signed: 03/10/2025 12:36:49 PM

Document Has Been Signed on 03/10/2025 12:36 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:BUILDING KIDZ SCHOOL - EUREKA (INF)FACILITY NUMBER:
313623044
ADMINISTRATOR/
DIRECTOR:		MYLIEGH GIBSONFACILITY TYPE:
830
ADDRESS:1485 EUREKA RD, STE G170TELEPHONE:
(916) 780-5437
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY: 7TOTAL ENROLLED CHILDREN: 7CENSUS: 5DATE:
03/10/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:David TuckerTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Jeremey McClain met with licensee David Tucker for an unannounced Case Management Inspection regarding an Unusual Incident Report.

LPAs observed 5 infant supervised by two staff members.

It was reported that on 2/12/2025, a child required medical attention due to seizure while in care. It was stated that a child had a fever while in care and the parents elected for the child to stay. Later that day a the child’s fever increased and the child started seizing. Paramedics and the child’s parents were called, and the child was transported to the hospital. During today’s inspection LPA reviewed files, conducted interviews with staff and discussed procedures moving forward with licensee.

An exit interview was conducted, and the report was reviewed with licensee David Tucker. A Notice of Site Visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2025
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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