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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623318
Report Date: 01/06/2022
Date Signed: 01/06/2022 01:29:05 PM

Document Has Been Signed on 01/06/2022 01:29 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:LILY PAD EARLY LEARNING CENTER, INC.FACILITY NUMBER:
313623318
ADMINISTRATOR:ZEMLICKA, MICHELLEFACILITY TYPE:
850
ADDRESS:1388 LINCOLN WAYTELEPHONE:
(530) 863-9443
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: 33TOTAL ENROLLED CHILDREN: 33CENSUS: 27DATE:
01/06/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Michelle Zemlicka - DirectorTIME COMPLETED:
01:45 PM
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On Thursday, January 6th, 2022, at 11:55am, Licensing Program Analyst (LPA) Blake Morillas conducted a Plan of Correction inspection to verify the resolution of the citation that was issued on the complaint visit conducted on 12-6-2021. LPA informed the Director, Michelle Zemlicka, of the reason for the inspection. Upon arrival, 27 preschool children and 3 staff were observed in the outdoor play area. During the headcount, no preschool children were observed inside the building.

On 12-6-2021, the facility was issued a Type B citation for failing to follow Covid-19 masking guidelines. When arriving to the facility, the Director was found inside, preparing lunch for the children in care. The Director was observed wearing a face shield. During my conversation with the Director, they stated that face shields have been purchased and supplied for the staff to use while in doors. Disposable masks are also provided for the staff to use as well.

Based on evidence obtained during today's inspection, the Plan of Correction has been met.

No deficiencies were cited during today's inspection.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Michelle Zemlicka.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Blake Morillas
LICENSING EVALUATOR SIGNATURE: DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2022
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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