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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340319034
Report Date: 08/29/2019
Date Signed: 08/29/2019 03:00:41 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:NICHOLAS PRESCHOOLFACILITY NUMBER:
340319034
ADMINISTRATOR:ROSALIE NUGENTFACILITY TYPE:
850
ADDRESS:6601 STEINER DRIVETELEPHONE:
(916) 433-5079
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:24CENSUS: 0DATE:
08/29/2019
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ahisha Lewis TIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Marea Behvand and Licensing Program Manager (LPM) Roxana Saravia met with Facilities and License Specialist, Ahisha Lewis and Coordinator, Noel Estacio for the purpose of an announced case management inspection. Licensee requested to make a room change. The capacity will remain the same. Facility is currently pending approval of the fire clearance for the new room K3. The facility operates as a state preschool in the mornings from 8:00 am -11:30 am and as a head start in the afternoon’s from 12:00 pm -3:30 pm.

A health and safety inspection was conducted in all areas accessible to children. LPA measured classroom. The total indoor capacity for the classroom is 831.75 square feet. This will accommodate Licensee's request for 24 preschool age children. There are two toilets and one sink. LPA observed a sufficient amount of chairs and tables. LPAs observed a refrigerator. LPAs observed a functional carbon monoxide detector, first aid kit, and medication box.

The total outdoor space was previously measured at 7382.46 square feet. This will accommodate Licensee's request for 24 preschool age children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). There is one play structure on the playground and there is shade provided by a canopy. There is a functional water fountain.

Facility staff was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request.

CONDITIONS REQUIRING CORRECTION PRIOR TO APPROVING INCREASE:


1. Fire clearance.

An exit interview was conducted and in the areas that were evaluated, no deficiencies were observed at the time of the inspection. Facilities and License Specialist signature on this form acknowledges receipt of this form. A Notice of Site Visit was provided and should remain posted for 30 days for parental review.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea BehvandTELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019
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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