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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623531
Report Date: 05/04/2023
Date Signed: 05/04/2023 12:43:59 PM

Document Has Been Signed on 05/04/2023 12:43 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:BUILDING KIDZ - ELK GROVEFACILITY NUMBER:
343623531
ADMINISTRATOR:RODRIGUEZ, KELLIEFACILITY TYPE:
830
ADDRESS:7511 WEST STOCKTON BLVDTELEPHONE:
(916) 688-5437
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
05/04/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Kellie RodriguezTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the facility director, Kellie Rodriguez, for a case management inspection.

During the annual inspection of the facility conducted on April 20, 2023, the facility did not had the record of present staff's educational qualifications. Therefore, the facility received a citation for operating out of ratio. After the licensing inspection, the facility personnel was able to locate staff's transcripts with required educational units. Based on the records available at this time, it was found that the facility is/was operating within ratio. During today's inspection, LPA provided the amended report from April 20, which shows the removal of citation for operating out of ratio and adding citation of not having all required documents on file, to the director. LPA informed the director that all of the required documents of each staff must be available for review during the Department's inspection. The director understood the requirement and agreed to maintain all of the records on file for future inspection.

Copy of this report was reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/04/2023
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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