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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620601
Report Date: 05/01/2019
Date Signed: 05/01/2019 09:23:54 AM

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:ROCK CREEK PRESCHOOL - CDIFACILITY NUMBER:
313620601
ADMINISTRATOR:SHALON WARNERFACILITY TYPE:
850
ADDRESS:2140 COLLET QUARY DRTELEPHONE:
(916) 788-4282
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY:24CENSUS: 19DATE:
05/01/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Shalon Warner and Amanda BarlowTIME COMPLETED:
09:08 AM
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Licensing Program Analyst (LPA) Jeremey McClain met with Program Director Amanda Barlow and Site Supervisor Shalon Warner for an unannounced Licensee Initiated Case Management Inspection. Upon arrival, LPA observed 19 preschool children, supervised by three staff members.

The licensee has requested to use another play ground structure and grass area that sits adjacent to current playground that is used. LPA made observations to the areas. LPA advised that 100% supervision be maintained when the playground and grass area is in use. There is opening in the gate that gives access to residential homes through a walk and bike path. Licensee plans to use traffic cones to block the area, as well as 100% supervision.

The facility has submitted a schedule showing that school age children and preschool children will use the area at separate times. The facility will continue to provide water and cups when the outside area is used.

As of today, the request to add the additional playground and grass area for additional outdoor space is approved.

LPA did not observe any violations of Title 22 Regulations during today’s inspection.
This report was reviewed with the license. LPA provided a Notice of Site Visit, which must remain posted for 30 days.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019
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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