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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619268
Report Date: 08/22/2024
Date Signed: 08/22/2024 11:09:43 AM

Document Has Been Signed on 08/22/2024 11:09 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LAURIA, STACIEFACILITY NUMBER:
343619268
ADMINISTRATOR/
DIRECTOR:		LAURIA, STACIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 505-1826
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
08/22/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Stacie Lauria TIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 08/22/2024, Licensing Program Analyst Katy Velazquez (LPA) conducted a Case Management inspection to verify corrections of a deficiency cited on 07/16/2024. LPA arrived at the facility and was met by an adult Aide (A1). Licensee Stacie Lauria (L1) arrived at the facility during LPA's file review. LPA disclosed the purpose of the inspection and was granted entrance into the facility. LPA toured the facility and observed 7 preschool aged children and 1 infant being supervised by A1. LPA determined, through accessing Guardian, that all required adults were background cleared.

On 07/16/2024, a Type-B deficiency was cited for incomplete staff files. LPA reviewed staff files on 08/22/2024 and ensured that all employees have files that contain all documentation as required by Title 22. The deficiency was cleared during today's inspection. A Proof of Correction letter was provided to L1.

No deficiencies were cited today in the areas that were evaluated. An exit interview was conducted, and the report was reviewed with Licensee Lauria. Licensee Appeal Rights were provided by LPA. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements will result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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