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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619205
Report Date: 05/12/2023
Date Signed: 05/12/2023 11:04:02 AM

Document Has Been Signed on 05/12/2023 11:04 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:UDY, VICKYFACILITY NUMBER:
343619205
ADMINISTRATOR:UDY, VICKYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 391-7010
CITY:SACRAMENTOSTATE: CAZIP CODE:
95831
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Vicky UdyTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Christopher Bello arrived at the facility for an unannounced annual inspection. Upon arrival licensee stated that she has retired and no longer interested in licensure. Licensee surrendered her license. LPA will close the facility effective 5/12/23.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE: DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2023
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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