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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620603
Report Date: 12/02/2019
Date Signed: 12/02/2019 02:17:01 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:CLUB ROCKLIN CDI - RUHKALA (SA)FACILITY NUMBER:
313620603
ADMINISTRATOR:MARTINEZ, STEPHANIEFACILITY TYPE:
840
ADDRESS:6530 TURNSTONE WAYTELEPHONE:
(916) 632-6560
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY:60CENSUS: 22DATE:
12/02/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Stephanie MartinezTIME COMPLETED:
02:30 PM
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Licensing Program Analysts (LPAs) Jeremey McClain and Amanda Blesi met with Site Supervisor Stephanie Martinez to conduct a case management inspection for a capacity increase. The Licensee wishes to increase overall capacity from 60 to 88 school age children, to be split between Portable A and Portable B.

During today's visit LPA observed the classrooms that will be utilized. The room is equipped with child size furnishings, including toys and learning equipment. There is storage for children's personal belongings. The facility has an on-site kitchen where food preparation will be done. Food items will be stored in the kitchen with a refrigerator and freezer used for the cold items. The facility will be serving lunch and afternoon snacks. Licensing observed a first aid kit, water will be available to children through a water fountain in the facility. Medications will be stored in the office and proper storage and usage will be maintained.

According to Title 22, Division 12, Sections 101538.2(c) & 101538.3(c), the school-age program is exempt from the indoor and outdoor square footage as well as the restroom requirements.

The facility operating hours for school age children will be from 7:00 am – 6:00 pm in Portable A, and 11:30 am – 6:00 pm in Portable B.

PORTABLE B MAY NOT BE USED FOR SCHOOL AGE CHILDREN WHILE PRESCHOOL CHILDREN ARE PRESENT.

Before approval, a final fire clearance must be received, as well as an updated facility sketch labeling both portables.

This report was reviewed with the Site Supervisor, and a Notice of Site Visit was provided.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2019
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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