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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343616736
Report Date: 12/02/2022
Date Signed: 12/05/2022 09:11:44 AM

Document Has Been Signed on 12/05/2022 09:11 AM - 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:CALVARY CHRISTIAN PRESCHOOLFACILITY NUMBER:
343616736
ADMINISTRATOR:ARRIAGA, SUSANFACILITY TYPE:
850
ADDRESS:4911 47TH AVENUETELEPHONE:
(916) 393-3633
CITY:SACRAMENTOSTATE: CAZIP CODE:
95824
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 11DATE:
12/02/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Hope CamarenaTIME COMPLETED:
02:30 PM
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On December 2, 2022, Licensing Program Analyst (LPA) Amanda Sutter met with Lead Teacher Hope Camarena for the purpose of an unannounced Plan of Correction inspection. LPA observed 11 children supervised by two staff. LPA observed staff files to be complete, therefore the deficiency issued on October 7, 2022 has been cleared.

Copy of this report was provided to the Lead Teacher. Notice of Site Visit and Appeal Rights were printed and provided to the Licensee.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2022
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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