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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343601391
Report Date: 09/03/2024
Date Signed: 09/03/2024 02:52:29 PM


Document Has Been Signed on 09/03/2024 02:52 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:JUST KIDS AT DISCOVERY TREE SCHOOLFACILITY NUMBER:
343601391
ADMINISTRATOR:KASEY YARBROUGHFACILITY TYPE:
850
ADDRESS:1235 H STREETTELEPHONE:
(916) 323-5301
CITY:SACRAMENTOSTATE: CAZIP CODE:
95814
CAPACITY:40CENSUS: 19DATE:
09/03/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Marisa BlevinsTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Pa Dao Vang met Director Marisa Blevins to conduct a Plan of Correction (POC) inspection on 9/3/2024 at around 2:45 PM. There were 2 Type B deficiency cited on 7/23/2024 for staff’s immunization and Mandated Reporter Training.

On today's date, LPA observed 19 children supervised by 3 staff during nap time. POC for staff’s immunization and Mandated Reporter Training are cleared as of 9/3/2024.

This report was reviewed with Director Marisa Blevins. A copy of this report and a notice of site visit was provided to be posted for 30 consecutive days.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Dao VangTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:
DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/03/2024
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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