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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343604948
Report Date: 04/11/2024
Date Signed: 04/11/2024 11:25:36 AM

Document Has Been Signed on 04/11/2024 11:25 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
343604948
ADMINISTRATOR/
DIRECTOR:		ROBERTS, DONYALEFACILITY TYPE:
850
ADDRESS:7901 LAGUNA BOULEVARDTELEPHONE:
(916) 691-3800
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 67DATE:
04/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Donyale RobertsTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 04/11/2024, Licensing Program Analyst Katy Velazquez (LPA) conducted a field visit to the facility for the purpose of a case management inspection regarding a self reported Unusual Incident Report (UIR) dated 04/08/2024. LPA arrived at the facility and was met by Director Donyale Roberts (D1). LPA disclosed the purpose of the inspection and was granted entrance. LPA observed a census of 67 preschool children during the time of the inspection. LPA determined through accessing Guardian that all required adults were background cleared and associated to the license.

LPA conducted staff interviews and requested a copy of the Facility Roster. The UIR reports that a complaint was made to the facility that a teacher grabbed a child by their sweatshirt. Interviews reveal that a child was "grabbed" by a teacher to remove the child from a chain link fence which the child was climbing during recess. No deficiencies were cited at the time of inspection on 04/11/2024.

An exit interview was conducted, and the report was reviewed with Director Roberts. LPA provided D1 with Licensee Appeal Rights. A Notice of Site visit was posted by LPA 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: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
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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