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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093616199
Report Date: 05/06/2022
Date Signed: 05/06/2022 01:09:43 PM

Document Has Been Signed on 05/06/2022 01:09 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:GIFT OF KIDS, THEFACILITY NUMBER:
093616199
ADMINISTRATOR:TOMMASINI, JENNIFERFACILITY TYPE:
830
ADDRESS:5130 GOLDEN FOOTHILLSTELEPHONE:
(916) 941-8751
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 18DATE:
05/06/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Jennifer TommasiniTIME COMPLETED:
01:25 PM
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On 05/06/2022, Licensing Program Analysts (LPAS) Arianna Manabat and Mai Lor met with Licensee Jennifer Tommasini for the purposes of an unannounced Case Management visit to clear deficiencies that were previously cited during an annual visit on 04/28/2022. During today's visit, LPAs observed eight cribs with labels which had included the three children who previously did not have assigned cribs. LPAs observed that all cribs had fitted sheets, indicated the days which each child would be present at the facility, and that crib was free from loose articles. During an interview with Director Diana Wise, it was indicated that the staff members were transferring from the room without cribs, name the One's room, to the room with the cribs.

Based off observation and interview, LPAs Arianna Manabat and Mai Lor have cleared the deficiency.
Notice of Site Visit was provided and shall remain posted for a period of 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2022
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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