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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623731
Report Date: 02/02/2023
Date Signed: 02/02/2023 11:48:11 AM

Document Has Been Signed on 02/02/2023 11:48 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:ZGAER, BANFACILITY NUMBER:
343623731
ADMINISTRATOR:ZGAER, BANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 255-3475
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
02/02/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Ban ZgaerTIME COMPLETED:
12:00 PM
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On February 2, 2023 Licensing Program Analysts (LPA) Lea Habtom arrived at the facility for a plan of correction of the citation issued on January 30, 2023 regarding ratio and infant safe sleep. At the time of arrival, there were 4 infants and 6 preschool children being supervised by licensee and her assistant. LPA L. Habtom confirmed that the infant play yards did not have any blankets or loose items and that the provider is documenting 15 minute sleep checks. LPA L. Habtom verified that the assistant completed the mandated reporter training with an expiration date of 2/2025. All staff present today have been fingerprint cleared and associated to the facility.

LPA L. Habtom cleared the citation issued on January 26, 2023 and provided a proof of correction letter. This report was reviewed with Ban Zgaer. No Title 22 regulations were cited during today's inspection. A notice of site visit was provided to be posted for 30 days. Appeal rights provided.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2023
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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