<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313610173
Report Date: 12/06/2023
Date Signed: 12/06/2023 02:38:08 PM

Document Has Been Signed on 12/06/2023 02:38 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:
12/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Jestine AttaranTIME COMPLETED:
02:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On December 6, 2023 Licensing Program Analyst (LPA) Lea Habtom met with director Jestine Attaran for the purpose of a Case Management Incident inspection.

At 1:05 pm there was a census of 11 transitional kindergarten children being supervised by 6 staff and the director. Around 1:50 pm 4 staff picked up 12 kindergarten children.

An Unusual Incident Report was submitted to the office on November 15, 2023. LPA Habtom interviewed director Jestine Attaran regrading the incident. It was reported that on November 14, 2023 around 1:52 pm 51 children were outside in the playground being supervised by 5 staff. Staff were getting ready to transition back into the art room when the staff realized 4 children did not respond to their name during role call. Staff went into lock down and notified the Principal and Assistant principal. Two STAR staff members and the Principal, Assistant principal and office staff were searching for the children around campus. The four children walked to a nearby home of one of the children and they were safely returned to the campus by a family member. The children were away from the program for approximately 15 minutes. Based on the self reported unusual incident and an interview with the director, Jestine Attaran, a Type A deficiency was cited on 809-D. Civil penalty assessed.

The director stated a staff meeting was held during work hours that went over changes made to avoid future incidents such as staff placement's on the playground. The director stated the playground perimeter was reduced to allow more staff visibility and highlighter yellow caution barricades were purchased to use as a barrier closed off to children.



Report continued on 809-C
Keven Peters
Lea Habtom
DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
Document Has Been Signed on 12/06/2023 02:38 PM - It Cannot Be Edited


Created By: Lea Habtom On 12/06/2023 at 02:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: S.T.A.R. TWELVE BRIDGES
FACILITY NUMBER: 313610173

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/07/2023
Section Cited

1
2
3
4
5
6
7
101229 Responsibility for Providing Care and Supervision: (a)The licensee shall provide care and supervision as necessary to meet the children's needs (1)No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1).
8
9
10
11
12
13
14
 Supervision shall include visual observation.
This requirement was not met as evidenced by when 4 children walked away from the facility for about 15 minutes and were later returned by a family member.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Keven Peters
TELEPHONE:
LICENSING EVALUATOR NAME:Lea Habtom
TELEPHONE:
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2023


LIC809 (FAS) - (06/04)
Page: 3 of 3
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: 12/06/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
This report was reviewed with the director, Jestine Attaran, and an exit interview was conducted. Appeal Rights and a Notice of Site Visit were provided.

LPA Lea Habtom informed director Jestine Attaran that this report dated 12/6/2023 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.


Also, LPA Lea Habtom informed the director Jestine Attaran to provide a copy of this licensing report dated 12/6/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISOR'S NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3