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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619029
Report Date: 02/11/2025
Date Signed: 02/11/2025 12:42:20 PM

Document Has Been Signed on 02/11/2025 12:42 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:LEE, RUBYFACILITY NUMBER:
343619029
ADMINISTRATOR/
DIRECTOR:		LEE, RUBYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 722-2458
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
02/11/2025
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Adelaida Anna Marie FerreeTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On February 11, 2025, Licensing Program Analyst (LPA), Michelle Perez, met with Reporting Party, Adelaida Anna Marie Feree and her duaghter, Aida Munts (DOB 1/14/2022).

LPA spoke to child Aida and mother (RP), to gather information regarding the complaint dated January 28, 2025.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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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