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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500446
Report Date: 09/10/2024
Date Signed: 09/10/2024 11:14:38 AM

Document Has Been Signed on 09/10/2024 11:14 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:FORTUNE PRESCHOOLFACILITY NUMBER:
344500446
ADMINISTRATOR/
DIRECTOR:		MICHELLE ROYFACILITY TYPE:
850
ADDRESS:9424 BIG HORN BOULEVARDTELEPHONE:
(916) 793-3671
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: 18DATE:
09/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Michelle RoyTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 09/10/2024, Licensing Program Analyst Katy Velazquez (LPA) conducted a Licensee initiated Case Management inspection for the purpose of a room change. LPA arrived at the facility and was met by Director Michelle Roy (D1). LPA disclosed the purpose of the inspection and was granted entrance into the facility. A Fire Clearance is on record with the Department. The current hours of operation are Monday thru Friday 7:00 am until 6:00 pm

INDOOR ACTIVITY SPACE:
The program is removing 2 classrooms. LPA observed a total of 3 sinks in the classrooms and 3 toilets in the classrooms. A shared bathroom waiver is on file with the Department, and the shared bathroom has 4 sinks and 6 toilets. LPA observed that the facility has a total of 7 sinks and 9 toilets. This is sufficient to meet the needs of 84 children. The facility’s current capacity is 84 preschool aged children. Licensee is not making a change to the licensed capacity. LPA used the current classroom measurements for classrooms 1, 3 and 5. The classrooms contain a total measurement of 2966.59 square feet which is enough to accommodate the licensed capacity of 84 preschool aged children. Individual measurements are recorded on the Capacity Worksheet LIC 9024 from a previous visit on 06/17/2024.

LPA is approving the use of classrooms 1, 3, and 5. No deficiencies were cited during today's inspection in the areas that were evaluated on 09/10/2024. An exit interview was conducted, and the report was reviewed with Director Roy. Licensee Appeal Rights was provided by LPA. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements will result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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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