<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621189
Report Date: 06/29/2023
Date Signed: 06/29/2023 01:24:53 PM

Document Has Been Signed on 06/29/2023 01:24 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:FU, YALIFACILITY NUMBER:
343621189
ADMINISTRATOR:YALI FUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 893-3063
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
06/29/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Yali FuTIME COMPLETED:
11:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Corina Beckby met with Licensee, Yali Fu on 06/29/2023 for the purpose of an unannounced plan of correction inspection to clear a Type B deficiency, which were issued on 05/24/2023.

LPA observed Licensee and cleared assistant caring for 12 preschool children including 1 toddler during today's inspection. LPA toured the facility and found no deficiencies.



LPA observed 12 children's files. All files are complete and up to date. This clears the last deficiency.

8 out of 8 Deficiencies cited on 05/24/2023 are cleared effective today. Proof of correction letters was provided for the last corrected deficiencies. LPA reviewed report with Licensee, Yali Fu. Appeal Rights were provided. A notice of site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1