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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622774
Report Date: 10/30/2024
Date Signed: 10/30/2024 12:30:59 PM

Document Has Been Signed on 10/30/2024 12:30 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:SILVA, ERIKAFACILITY NUMBER:
343622774
ADMINISTRATOR/
DIRECTOR:		SILVA, ERIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 366-8571
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
10/30/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Erika SilvaTIME VISIT/
INSPECTION COMPLETED:
12:21 PM
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Licensing Program Analyst (LPA) Corina Beckby met with Erika Silva to deliver an amended report.

LPA toured the facility and observed the care and supervision of children

Exit interview was conducted. A Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, no deficiencies were cited during today's inspection.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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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