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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
344500154
Report Date:
11/25/2024
Date Signed:
11/25/2024 11:15:40 AM
Document Has Been Signed on
11/25/2024 11:15 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
SACRAMENTO S. CC RO
,
9835 GOETHE ROAD, SUITE 100
SACRAMENTO
,
CA
95827
FACILITY NAME:
REYES, JOLENE
FACILITY NUMBER:
344500154
ADMINISTRATOR/
DIRECTOR:
REYES, JOLENE
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(209) 251-3129
CITY:
GALT
STATE:
CA
ZIP CODE:
95632
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
14
CENSUS:
DATE:
11/25/2024
TYPE OF VISIT:
Required - 3 Year
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:
TIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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Karyn Guerra
TELEPHONE:
(916) 216-7790
Katy Velazquez
TELEPHONE:
916-926-9100
DATE:
11/25/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/25/2024
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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