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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343600374
Report Date: 12/28/2022
Date Signed: 12/28/2022 12:56:10 PM

Document Has Been Signed on 12/28/2022 12:56 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:SUNRISE KIDS CLUB - OAK HILL DAYCAREFACILITY NUMBER:
343600374
ADMINISTRATOR:MARTELL, FELISAFACILITY TYPE:
840
ADDRESS:3909 NORTH LOOP BLVDTELEPHONE:
(916) 331-6042
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 16DATE:
12/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Felisa Martell and Kourtney HobartTIME COMPLETED:
01:15 PM
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On December 28, 2022 at 10:45 AM Licensing Program Analyst (LPA) Amanda Blesi met with director Felisa Martell for a case management inspection to discuss the unusual incident report (UIR) that the program submitted and which occurred on December 08, 2022. During today's inspection, there were 16 preschool children supervised by three staff and director. Recreation Services Manager, Kourtney Hobart arrived later during the inspection.

LPA spoke with staff and children and reviewed written declarations from staff who witnessed the incident but were not present today to be interviewed. The UIR states that on 12/08/22 child #1 was throwing items around the classroom and attempting to kick and hit staff #1. Staff #1 then held child #1's arms and helped child #1 sit down in a chair as the child continued to kick and hit. Based on the interviews and evidence gathered today, LPA concluded a personal rights violation did not occur during the incident.

Exit interview conducted and report was reviewed with facility representative's Kourtney Hobart and Felisa Martell. 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
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE: DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/28/2022
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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