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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621189
Report Date: 07/08/2024
Date Signed: 07/08/2024 11:20:09 AM

Document Has Been Signed on 07/08/2024 11:20 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:FU, YALIFACILITY NUMBER:
343621189
ADMINISTRATOR/
DIRECTOR:		YALI FUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 893-3063
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
07/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Yali FuTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Corina Beckby met with Licensee, Yali Fu on 07/08/2024 for the purpose of an unannounced plan of correction inspection to clear Type B deficiencies which were issued on 06/06/2024. Licensee is limited in English so LPA and Licensee communicated with Google Translate (Mandarin) when needed.

LPA observed Licensee and assistant caring for 7 preschool children during today's inspection. LPA reviewed staff and children's files for compliance. LPA toured the facility and found no deficiencies.



The Type B deficiencies cited on 06/06/ 2024 are cleared effective today. Proof of correction letter was provided for the corrected deficiencies. LPA reviewed report with Licensee, Yali Fu. 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: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2024
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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