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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340308278
Report Date: 09/19/2024
Date Signed: 09/19/2024 03:59:01 PM

Document Has Been Signed on 09/19/2024 03:59 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:MOREY AVENUE ECDCFACILITY NUMBER:
340308278
ADMINISTRATOR/
DIRECTOR:		FISHER HILL, MIKAKOFACILITY TYPE:
850
ADDRESS:155 MOREY AVENUETELEPHONE:
(916) 566-3485
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY: 232TOTAL ENROLLED CHILDREN: 232CENSUS: 95DATE:
09/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Mikako Fisher HillTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Pa Dao Vang met Director Mikako Fisher Hill to follow up on the UIR incident submitted to the regional office on 9/6/2024.

On today's date, LPA observed a census of 69 preschool children supervised by 19 staff and 26 toddlers supervised by 6 staff. LPA conducted interviews, made observations, and inspected the playground area. In all areas inspected, there are no Title 22 violation.

This report was reviewed with Director Mikako Fisher Hill. A copy of this report, appeal rights, and a notice of site visit was provided to be posted for 30 consecutive days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
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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