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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622998
Report Date: 05/29/2024
Date Signed: 05/29/2024 01:41:00 PM

Document Has Been Signed on 05/29/2024 01:41 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:ARECHIGA, DIANEFACILITY NUMBER:
343622998
ADMINISTRATOR/
DIRECTOR:		ARECHIGA,DIANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 919-1605
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
05/29/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Arechiga, DianeTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 5/29/2024 at approximately 12:00 p.m., License Program Analyst (LPA) Pa Dao Vang met with the Licensee Diane Arechiga for the purpose of a Case Management inspection. LPA followed up on the Unusual Incident Report submitted to the Sacramento Regional Office on 5/22/2024. Upon arrival, LPA observed a total census of 3 children, consisting of 2 of Licensee's own children and a day care child.

LPA Vang confirmed the off and on limit areas and discussed about the off limit areas must be closed at all times during day care hours.

No Tile 22 Regulation being cited today. An exit interview is conducted with Licensee Diane Arechiga. A copy of the this report, apple rights, and a Notice of Site Visit are provided to Licensee.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE: DATE: 05/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/29/2024
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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