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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313610174
Report Date: 08/17/2023
Date Signed: 08/17/2023 12:13:47 PM


Document Has Been Signed on 08/17/2023 12:13 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. CREEKSIDE OAKSFACILITY NUMBER:
313610174
ADMINISTRATOR:SOFIA RAMIREZFACILITY TYPE:
840
ADDRESS:2030 FIRST STREETTELEPHONE:
(916) 434-8085
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY:60CENSUS: 0DATE:
08/17/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Andrea BrandTIME COMPLETED:
12:20 PM
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On August 17, 2023 Licensing Program Analyst (LPA) Lea Habtom met with Program Coordinator Andrea Brand, for the purpose of a case management inspection. The STAR facility is located on the Creekside Oaks Elementary School campus. Upon arrival, there were no children present. At 11:55 am 5 transitional kindergarten children were picked up by two staff members. All individuals subject to criminal background review have obtained criminal record clearance. All criminal record clearances are associated to Oak Hills STAR facility #313600444.

The facility wishes to add room #28 and remove rooms 3, 8 & 9 keeping the capacity at 60. An updated LIC 200A will be provided to remove classrooms 3, 8 & 9. The facility will be utilizing the toilets and playground on school campus. Cubbies were observed in the room. Fire clearance was granted on August 15, 2023 by Lincoln Fire Department for 60 school age children. Children have their personal water bottles and the classroom also has a water pitcher as well as a water fountain.

Effective today, Wednesday, August 17, 2023 LPA is granting a room addition to room #28.

There were no deficiencies cited during today's visit. An exit interview was conducted with Andrea Brand. Notice of Site Visit provided and shall remain posted for 30 days.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023
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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