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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313622153
Report Date: 09/18/2024
Date Signed: 09/18/2024 11:19:46 AM

Document Has Been Signed on 09/18/2024 11:19 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LITTLE SUNSHINE'S PLAYHOUSE & PS - GRANITE BAYFACILITY NUMBER:
313622153
ADMINISTRATOR/
DIRECTOR:		MARCI PILGRIMFACILITY TYPE:
850
ADDRESS:5370 DOUGLAS BLVDTELEPHONE:
(916) 605-0217
CITY:GRANITE BAYSTATE: CAZIP CODE:
95746
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 50DATE:
09/18/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Marci PilgrimTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analysts (LPAs) Jeremey McClain met with facility representative Marci Pilgrim for an unannounced Case Management Inspection regarding an Unusual Incident Report.

LPAs observed 50 children supervised by nine staff members.

It was reported that on 9/9/2024, a child suffered a cut to their head while on the playground. The child attended to immediately by staff, and their parents were contacted. The child was later given stitches by a medical professional and returned to care the following day. During today’s inspection LPA interviewed the staff and observed the playground. LPA determined there were not any violations of Title 22 regulations.

An exit interview was conducted, and the report was reviewed with facility representative Marci Pilgrim. A Notice of Site Visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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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