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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340319284
Report Date: 05/06/2022
Date Signed: 05/06/2022 02:34:03 PM


Document Has Been Signed on 05/06/2022 02:34 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:SKYCREST STATE PRESCHOOLFACILITY NUMBER:
340319284
ADMINISTRATOR:RAMERIZ, DRINAFACILITY TYPE:
850
ADDRESS:5641 MARIPOSA AVENUETELEPHONE:
(916) 867-2103
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:48CENSUS: 17DATE:
05/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Jonna WiliamsTIME COMPLETED:
02:40 PM
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At 2:00 p.m. on Friday, May 6th, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Staff, for the purpose of a required - 1 year inspection. LPA observed a census of 17 preschool children supervised by 4 staff. Hours of operation for the program are from 8:00 a.m. - 2:30 p.m., Monday thru Friday. Minimum day is on Thursdays with closure 11:45 a.m. Program operates in classrooms C1 and C2, and receives state funds.

Criminal record clearance is on file with San Juan Unified School District. Director 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.

LPA conducted a health and safety inspection of the classrooms, restrooms, and food service areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat laws, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. LPA conducted a health and safety inspection of the outdoor space. Playground equipment and surfaces were free of loose or sharp parts. LPA observed wood chips to provide cushioning. Outdoor shade was provided by canopies and trees. Water is accessible via labeled bottles. Bins for solid waste have tight fitting lids. LPA observed sign in and sign out logs with full legal signature of parent/guardians.

The facility closes at 2:30 p.m. today. An follow up inspection will be conducted to review files and complete the required - 1 year inspection. An exit interview was conducted and a notice of site visit provided. Notice of site visit shall remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:
DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2022
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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