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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340318374
Report Date: 05/22/2023
Date Signed: 05/22/2023 02:42:39 PM


Document Has Been Signed on 05/22/2023 02:42 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:CORDOVA VILLA ELEMENTARY SCHOOLFACILITY NUMBER:
340318374
ADMINISTRATOR:PEREZ, AUNDRIA CHAVEZFACILITY TYPE:
850
ADDRESS:10460 REYMOUTH AVENUETELEPHONE:
(916) 294-9124
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY:22CENSUS: 15DATE:
05/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Teresa CrossmanTIME COMPLETED:
03:00 PM
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Licensing Program Analyst Erwina Pascual-Golamco (LPA) met with Site Supervisor (SS) Teresa Crossman, for an unannounced annual inspection. LPA toured the facility in Preschool Building #26, including all activity and classroom spaces, restrooms, and outdoor play areas. The following areas are in compliance during the visit. Census included 15 preschool children being supervised by 3 classroom staff. SS was reminded never to exceed the conditions, limitations, and capacity specified on the license. Facility hours of operation are Monday through Friday from 8:00am to 11:00am and an afternoon class from 11:45am to 2:45pm following the Folsom Cordova Unified School District (FCUSD) Calendar. Children do not take naps. All staff present had evidence of current criminal background clearances and/or associations through the FCUSD.

SS was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.



Classroom is orderly, and free from hazards. Chemicals were kept inaccessible to children. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to cushion fall. Uncontaminated drinking water was readily available to children both indoors and outdoors, children also bring their own water bottles from home. The facility provides Breakfast and lunch through the food services provided by FCUSD. LPA observed a posted menu.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-GolamcoTELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2023
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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