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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500712
Report Date: 10/11/2022
Date Signed: 10/11/2022 09:56:34 AM

Document Has Been Signed on 10/11/2022 09:56 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:ELK GROVE KIDS CAMPFACILITY NUMBER:
344500712
ADMINISTRATOR:AMALI, KIMBERLYFACILITY TYPE:
840
ADDRESS:9360 ELK GROVE FLORIN RD STE 4TELEPHONE:
(916) 685-7462
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 28TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/11/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kim Amali TIME COMPLETED:
10:00 AM
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Application Specialist (AS) Alecia Sifuentes, Licensing Program Manager (LPM) Bettina Engelman, and Licensing Program Analyst (LPA) Salene Mayberry met with Applicant/Licensee Representative Kim Amali and Fire Inspector II Robert Haupert for the purpose of an announced preliminary pre-licensing inspection. Applicant requests a school-age license to serve 28 school-age children from kindergarten and above. The program will operate Monday through Friday from 8:00 a.m. to 5:00 p.m. There is another business, Sunshine Swim Center that is located at the same address that is owned and operating by Kim Amali. Kim stated that the swim business will not have access to the classroom, outdoor activity area, and children’s bathrooms during the operating hours of the child care program.

INDOOR AND OUTDOOR ACTIVITY SPACE:
There is one school-age classroom and one outdoor play area. . AS did not take measurements. AS observed two doors leading outside to the swim center pool. Kim stated that the doors are locked at all times. AS observed that there is a five foot tall wrought iron fence that separates the classroom door and outdoor space door from the pool area. AS observed that the fence gate swings away from the pool and self latches. The outdoor play area is fenced with a wrought iron fence and a cinder block wall that is at least four feet tall.

Exit interview conducted and report was reviewed with the Applicant/Licensee Representative, Kim Amali.

The following items are required before a license will be issued:
1. Final file review from LPM
2. Pool Safety Plan
3. Second pre-licensing inspection
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2022
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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