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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500429
Report Date: 10/16/2024
Date Signed: 10/16/2024 03:03:12 PM

Document Has Been Signed on 10/16/2024 03:03 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ACADEMY OF CHILD DEVELOPMENT & AMOREFACILITY NUMBER:
394500429
ADMINISTRATOR/
DIRECTOR:		AIDA LOMELIFACILITY TYPE:
830
ADDRESS:170 EAST FRENCH CAMP ROADTELEPHONE:
(209) 898-2958
CITY:FRENCH CAMPSTATE: CAZIP CODE:
95321
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 3DATE:
10/16/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Katheryne DouglassTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 10/16/2024, Licensing Program Analysts (LPAs) Lauren Scott and Janie Davis met with facility representative, Katheryne Douglass. LPAs arrived at the facility to conduct an unannounced Plan of Correction (POC) inspection to verify corrections of deficiencies cited on 09/25/2024. On that date, facility was cited for two Type B citations, regarding physical plant and sign in/ outs.

LPA's toured the facility, and reviewed records. LPAs observed sign in and out sheets to be properly completed, as well as the infant nap room to be clean/ organized.

An exit interview was conducted with Facility Representative Katheryne Douglass. Facility Representative was given a copy of Appeal Rights. A notice of Site Visit was posted by the LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2024
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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