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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343601206
Report Date: 03/11/2024
Date Signed: 03/11/2024 01:55:17 PM

Document Has Been Signed on 03/11/2024 01:55 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ACTION DAY LEARNING CENTERFACILITY NUMBER:
343601206
ADMINISTRATOR:HARLAND, MARIA (BUFFY)FACILITY TYPE:
840
ADDRESS:9371 ELM AVENUETELEPHONE:
(916) 988-9633
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 0DATE:
03/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Maria "Buffy" HarlandTIME COMPLETED:
02:15 PM
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An unannounced case management inspection was conducted by Licensing Program Analyst (LPA) Jennifer Velasco. LPA met with facility representative, Joyce Campbell (Admin), who was advised of the purpose of this inspection. This inspection was conducted to follow up on an unusual incident that was self-reported to Community Care Licensing (CCL) as required. During this inspection, LPA toured the facility, conducted interviews, and reviewed relevant facility documentation.

Based on LPA review of facility documents and witness statements, no deficiencies are cited. Exit interview with Admin Joyce Campbell was conducted. Notice of site visit was provided and must be posted for 30 consecutive days for parental review.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2024
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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