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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622941
Report Date: 01/31/2022
Date Signed: 01/31/2022 02:31:14 PM

Document Has Been Signed on 01/31/2022 02:31 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:MCLORIN-JACKSON,SONYAFACILITY NUMBER:
343622941
ADMINISTRATOR:MCLORIN-JACKSON,SONYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 226-7054
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
01/31/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Sonya McLorin-JacksonTIME COMPLETED:
03:00 PM
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On Monday 01/31/2022 at 2:20pm, Licensing Program Analyst (LPA) Jan Hoshida met with Licensee Sonya McLorin-Jackson for a Proof of Correction (POC) inspection to clear one Type A deficiency that were cited on 01/11/2022. Upon arrival, LPA observed three children with Licensee.

LPA observed that the kitchen cabinets containing cleaning items labeled "keep out of reach of children" had working latches.

LPA cleared the Type A citation cited on 01/11/2022 and provided Licensee with a letter of deficiency of citations cleared.

Notice of Site visit posted. An exit interview was conducted with Licensee.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2022
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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