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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622983
Report Date: 10/13/2022
Date Signed: 10/13/2022 12:04:34 PM

Document Has Been Signed on 10/13/2022 12:04 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:SINGLE MOM STRONG - EMPOWERME PRESCHOOL CHILDCAREFACILITY NUMBER:
343622983
ADMINISTRATOR:KINZ, KIMBERLYFACILITY TYPE:
850
ADDRESS:7525 AUBURN BLVD, SUITE 5TELEPHONE:
(916) 735-5350
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 27TOTAL ENROLLED CHILDREN: 27CENSUS: 12DATE:
10/13/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Tara TaylorTIME COMPLETED:
12:15 PM
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At 10:15 a.m. on Thursday, October 13th, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Licensee, Tara Taylor, for the purpose of an unannounced case management - licensee initiated inspection. LPA observed a census of 12 preschool children supervised by 2 staff. The facility requests to add a toddler component of 12 children to the license. The facility also requests an increase in total capacity from 27 to 39 children. A fire clearance is on file with the department.

INDOOR ACTIVITY SPACE:
The toddler classroom space was measured and documented on a capacity worksheet. The space will accommodate the requested capacity increase of 12 children. LPA inspected the toddler classroom and observed adequate tables, chairs, and napping mats. LPA also observed a changing table and age appropriate materials and equipment for children. There is a total of 2 toilets and 1 sink in the toddler classroom.

OUTDOOR ACTIVITY SPACE:
The outdoor space was previously measured and has not changed. There is a rotating play space waiver on file as the outdoor space will not accommodate the requested capacity. An updated outdoor schedule is on file with the department. LPA reminded Licensee that equipment used by toddler children shall be age appropriate.

Effective today, October 13th, the addition of the toddler component and capacity increase is approved. No deficiencies were cited during today's inspection. This report was reviewed with the Licensee and an exit interview was conducted. A notice of site visit was provided and shall remain posted for a period of 30 days for parental review.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2022
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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