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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313614598
Report Date: 08/10/2021
Date Signed: 08/10/2021 12:02:15 PM

Document Has Been Signed on 08/10/2021 12:02 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:STAR LINCOLN CROSSINGFACILITY NUMBER:
313614598
ADMINISTRATOR:PETERS, RACHELFACILITY TYPE:
840
ADDRESS:635 GROVELAND LANETELEPHONE:
(916) 409-0797
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY: 250TOTAL ENROLLED CHILDREN: 0CENSUS: 54DATE:
08/10/2021
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Rachel PetersTIME COMPLETED:
11:00 AM
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LPA met with site director, Rachel Peters to conduct an announced (due to COVID-19) case management inspection for the purpose of interviewing a child for a complaint that is unrelated to this facility. Child #1 was interviewed today in the school front office for a complaint on a family day care home the child previously attended.

Notice of site visit posted and shall remain posted for 30 days.
No deficiencies were cited during today's inspection.
Keven Peters
Amanda Blesi
DATE: 08/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2021
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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