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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617215
Report Date: 08/08/2022
Date Signed: 08/08/2022 01:41:15 PM

Document Has Been Signed on 08/08/2022 01:41 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:KELLI'S PALS PRESCHOOL & DAY CAREFACILITY NUMBER:
343617215
ADMINISTRATOR:BOYD, LINFACILITY TYPE:
850
ADDRESS:501 SAN JUAN ROADTELEPHONE:
(916) 922-0724
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 22DATE:
08/08/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Lin BoydTIME COMPLETED:
02:00 PM
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On Monday, August 8, 2022 at 12:45 PM, Licensing Program Analyst (LPA) Amanda Sutter met with Director Lin Boyd for the purpose of an unannounced plan of correction inspection. LPA observed 22 children supervised by 5 staff. All individuals subject to criminal background review have obtained a criminal record clearance. LPAs observed 24 children supervised by 6 staff.

LPA observed proper ratio being maintained and will clear the deficiencies cited on 7/29/22 for deficiency 101216.3(a).

LPA observed proof of completed mandated reporter training for all staff present as well as completed staff files. LPA will clear the deficiencies cited on 7/7/2022 for HSC 1596.8662(b)(1) and CCR 101216(g)(1).

LPA observed cleaning supplies in school age kitchen to be stored properly and will clear the deficiency cited on 7/7/2022 for 101238(g).

LPA reviewed 5 children files. All child files were observed to be complete. LPA will clear the deficiency cited on 7/7/2022 for 101221(a).

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Lin Boyd.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2022
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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