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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621662
Report Date: 09/08/2023
Date Signed: 09/08/2023 12:37:09 PM

Document Has Been Signed on 09/08/2023 12:37 PM - 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TINY TOTS ACADEMYFACILITY NUMBER:
393621662
ADMINISTRATOR:CANDI KETTGENFACILITY TYPE:
850
ADDRESS:250 NORTHGATE DRIVETELEPHONE:
(209) 294-9803
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY: 43TOTAL ENROLLED CHILDREN: 43CENSUS: 36DATE:
09/08/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Candi KettgenTIME COMPLETED:
12:45 PM
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On 09/08/2023 at 11:15 AM, Licensing Program Analyst (LPA) Tiffanie Diep met with Licensee Candi Kettgen for the purpose of an unannounced Plan of Correction (POC) inspection. LPA observed seven staff supervising 36 children.

All individuals subject to a criminal record review have obtained a criminal record clearance. Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

During an annual inspection conducted on 07/27/2023, Licensee was issued a Type B citation as personnel records were not maintained for three staff. During today’s visit, LPA verified the required personnel documents for all staff. The deficiency is cleared effective today, September 8, 2023. A POC letter was provided to Licensee.

An exit interview was conducted and report was reviewed with the licensee, Candi Kettgen. A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2023
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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