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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619183
Report Date: 01/22/2024
Date Signed: 01/22/2024 02:56:45 PM

Document Has Been Signed on 01/22/2024 02:56 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:TAYLOR, FELICIAFACILITY NUMBER:
343619183
ADMINISTRATOR:TAYLOR, FELICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 996-1053
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Felicia TaylorTIME COMPLETED:
02:30 PM
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On January 22nd, 2024 Licensing Program Analyst (LPA) Mandie Goodwin met with Licensee Felicia Taylor for the purpose of a case management to obtain signatures on an amended report.

During today's inspection no deficiencies were observed.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2024
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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