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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623795
Report Date: 03/09/2023
Date Signed: 03/13/2023 08:44:34 AM

Document Has Been Signed on 03/13/2023 08:44 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:PALOMBO, SANDRAFACILITY NUMBER:
343623795
ADMINISTRATOR:PALOMBO, SANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 385-7219
CITY:SACRAMENTOSTATE: CAZIP CODE:
95826
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
03/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Sandra PalomboTIME COMPLETED:
12:30 PM
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Licensing Program Analysts (LPAs) Gagandeep Singh and David Nguyen, met with the licensee, Sandra Palombo, for a case management inspection related to an incident. Also, during the inspection, licensee requested the LPAs to inspect the bathroom in the hallway before start using for the day care. Purpose of the inspection was explained.

The facility self reported that on February 15, 2023, while playing a child hurt his arm and the child was taken to the hospital by the parent. During today's inspection, LPAs inspected the day care areas and interviewed the licensee. Per licensee, on February 15, 2023, children were playing in the play room and one child reported that child's arm was hurting. Per licensee, licensee informed the parents and comforted the child. Per licensee, child was taken to the hospital and no fractures were found. Per licensee, the child was back in care on February 17, 2023 and child was present during today's inspection.

During inspection, LPAs inspected the bathroom in the hallway. There are no cabinets in the bathroom. LPAs observed licensee has all of the chemicals inaccessible for the children and there no hazards in the bathroom. As of today, Bathroom in the hallway is added to the day care areas.

During the inspection and interview, no violation of any regulations was observed. Copy of this report was reviewed and provided to the licensee. 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: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/09/2023
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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