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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622984
Report Date: 03/28/2023
Date Signed: 03/28/2023 11:24:57 AM

Document Has Been Signed on 03/28/2023 11:24 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:SINGLE MOM STRONG - EMPOWERME PRESCHOOL CHILDCAREFACILITY NUMBER:
343622984
ADMINISTRATOR:KINZ, KIMBERLYFACILITY TYPE:
840
ADDRESS:7525 AUBURN BLVD, SUITE 5TELEPHONE:
(916) 735-5350
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 0DATE:
03/28/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Tara TaylorTIME COMPLETED:
10:40 AM
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At 9:10 a.m. on Tuesday, March 28th, 2023, Licensing Program Analysts (LPAs) Karyn Guerra and Mai Lor met with Licensee, Tara Taylor, for the purpose of a case management - licensee initiated inspection. No school age children were present during time of inspection. Licensee requests a room change and capacity change. School age children will now be using the workshop space, previously licensed for the preschool program. Preschool children will now be using both classrooms with doors. Licensee requests a decrease in capacity from 28 to 20 school age children. An updated application form LIC200A was received during inspection.

Indoor activity space
The indoor activity space was measured previously. Total square footage of the indoor play space in the newly designated school age workshop classroom measures 706.5 square feet. The indoor square feet will accommodate the requested capacity of 20 children.

Outdoor Activity Space
The outdoor play area is fenced and shade is provided. The outdoor activity space was previously measured during a prelicensing inspection and has not changed. The space will accommodate the capacity of 20 school age children. Age appropriate materials are available in bins. There is a shared play space waiver on file.

No deficiencies were cited during today's inspection. This report was reviewed with the Licensee, Tara Taylor, and an exit interview was conducted. A notice of site visit was provided and shall remain posted for 30 days.

The following corrections are needed prior to room and capacity change approval:

1. The department shall receive an approved updated fire clearance.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2023
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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