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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313621168
Report Date: 12/20/2019
Date Signed: 12/20/2019 11:40:37 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:STEPPING STONES PRESCHOOL (INF)FACILITY NUMBER:
313621168
ADMINISTRATOR:PINION, LORIEFACILITY TYPE:
830
ADDRESS:1001 STONE CANYON DRIVETELEPHONE:
(916) 772-9304
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:17CENSUS: 10DATE:
12/20/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Lorie PinionTIME COMPLETED:
11:50 AM
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Licensing Program Analyst (LPA) Jeremey McClain met with Director Lorie Pinion for an unannounced Case Management Inspection regarding an Unusual Incident Reported received via mail.

Upon arrival, LPA observed 10 infants in two rooms, supervised by four staff members.

It was reported that on 12/09/2019 that a child fell and hit a tree root on the playground. The child’s tooth was broken as a result of the incident. During today’s inspection, LPA observed the playground where the incident happened, and viewed recorded footage of the incident. LPA determined that there were not any violations of Title 22 regulations from the incident.

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: 12/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019
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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