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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313610173
Report Date: 06/12/2023
Date Signed: 06/12/2023 10:42:28 AM

Document Has Been Signed on 06/12/2023 10:42 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:S.T.A.R. TWELVE BRIDGESFACILITY NUMBER:
313610173
ADMINISTRATOR:ATTARAN, JESTINEFACILITY TYPE:
840
ADDRESS:2450 EASTRIDGE DR.TELEPHONE:
(916) 434-6542
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 67DATE:
06/12/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Connie GaudioTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Jeremey McClain met with Site Director Connie Gaudio for the purpose of a capacity increase. The center is currently licensed for 100 school age children. Room #301 and #302 will be added to spaced that is currently approved. 67 children were present with 11 staff. LPA conducted a health and safety evaluation of rooms 301 and 302.

LPA did not take measurements on this day as this is a school age program operating on a functioning elementary school site. LPA observed age appropriate furniture and equipment. First aid supplies and storage space were observed. Facility uses the school playground and bathrooms.

An approved fire clearance was granted for 250 on 06/01/2023 children today during the inspection.

Effective today 06/12/2023, facility is approved to use rooms 301 and 302 and a capacity of 250 school age children.

Exit interview was conducted and notice of site visit posted.
Keven Peters
Jeremey McClain
DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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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