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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

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:250CENSUS: 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.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

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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