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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340306383
Report Date: 09/19/2024
Date Signed: 09/19/2024 03:42:39 PM

Document Has Been Signed on 09/19/2024 03:42 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:MARVIN MARSHALL CHILDREN'S CENTERFACILITY NUMBER:
340306383
ADMINISTRATOR/
DIRECTOR:		VONG,JACK,MANI, REYNOLDSFACILITY TYPE:
850
ADDRESS:5309 KENNETH AVENUETELEPHONE:
(916) 971-7380
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 209TOTAL ENROLLED CHILDREN: 209CENSUS: 17DATE:
09/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Isabelle McDanielTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On September 19, 2024 at approximately 2:05 PM Licensing Program Analyst Josiah Gathing met with Preschool Administrator Isabelle McDaniel for the purpose of an unannounced Case Management investigation. The purpose of this inspection was to investigate three separate incident reports submitted to 'the Licensing program on August 21, 2024 and September 13, 2024. During the investigation LPA conducted interviews and made observations.

A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with the Preschool Administrator. This report and appeal rights were printed and provided to the Preschool Administrator. No deficiencies were cited during today's investigation.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
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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