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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313610173
Report Date: 09/08/2023
Date Signed: 09/08/2023 01:14:19 PM

Document Has Been Signed on 09/08/2023 01:14 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: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: 250TOTAL ENROLLED CHILDREN: 250CENSUS: 11DATE:
09/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Jestine AttaranTIME COMPLETED:
01:25 PM
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On Friday, September 8, 2023 Licensing Program Analyst (LPA) Lea Habtom arrived to the facility and met with director Jestine Attaran to conduct a 1-year required annual inspection. The facility is located on Twelve Bridges Elementary School grounds in the art room, gym and room #313 (not being used at this time). Upon arrival there were 11, T-K children being supervised by 5 staff and the site supervisor.

LPA conducted a health and safety evaluation in areas used by the facility. They share the outdoor play and restrooms with the elementary school. LPA reviewed care and supervision of children, staffing ratios, health related services, furniture, equipment, drinking water, and food service provisions. Parents provide snacks.

LPA reviewed the children's Identification and Emergency Information. LPA reviewed personnel's education and immunization requirements. All staff currently employed with the center have criminal record clearances and are associated to the STAR Oakhills facility #313600444; a waiver is on file and waiver is posted. At least one staff member present today has current EMSA approved Pediatric/Child CPR and First Aid.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated


Report is continued on following page LIC 809-C
Keven Peters
Lea Habtom
DATE: 09/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: S.T.A.R. TWELVE BRIDGES
FACILITY NUMBER: 313610173
VISIT DATE: 09/08/2023
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s personnel, and administrative records. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Center Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 513-0301 (voice)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA available at: http:www.ada.gov/childqanda.ht

PA provided the Community Care Licensing’s website www.ccld.ca.gov, so the director can obtain updated licensing information, new regulations and access forms. LPA advised director of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.



No Title 22 regulations were cited during today's inspection. Exit interview conducted and report was reviewed with the Jestine Attaran. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
SUPERVISOR'S NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2023
LIC809 (FAS) - (06/04)
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