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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343601750
Report Date: 10/16/2023
Date Signed: 10/16/2023 12:27:34 PM

Document Has Been Signed on 10/16/2023 12:27 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CHARLES E. MACK PRESCHOOLFACILITY NUMBER:
343601750
ADMINISTRATOR:COLLIER, ROBERTAFACILITY TYPE:
850
ADDRESS:4701 BROOKFIELD DRIVETELEPHONE:
(916) 422-1566
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 11DATE:
10/16/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Deborah SantanaTIME COMPLETED:
10:45 AM
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On October 16th, 2023, Licensing Program Analyst (LPA) Gagandeep Singh and Centralized Application Bureau's (CAB's) LPA Arianna Manabat met with facility representative, Deborah Santana, to conduct an inspection to change of the capacity of the preschool. The facility has requested an decrease in capacity from 72 to 24 preschool children. There are currently 11 children in care with three staff members. The facility's hours of operation are 8:00 AM to 11:00 AM and 11:45 AM to 3:15 PM from Monday to Thursday.

A health and safety inspection was conducted in all areas accessible to children. There is one preschool room (B1) and two bathrooms. LPAs inspected and took measurements of the preschool classroom. The total indoor space of the new classroom is 1081.41 square feet which will accommodate the request for 24 children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). The approved fire clearance was received from the Fire Department on 10/5/2023.

LPAs observed sufficient amount of furniture, toys, cubbies, and play equipment in the classrooms. LPAs observed 2 toilets and 2 sinks inside of the classrooms for the preschool children to use. LPAs observed the outdoor play areas which are fenced and equipped with a sufficient amount of play equipment and toys and material to absorb a fall. During today's inspection, LPAs observed multiple safety information stickers with conflicting information about the appropriate ages which can utilize the play structure.

There are no bodies of water on the premises. There is shade provided by canopies and trees. Water is made available for children via a drinking fountain indoor and outdoor. LPAs measured the outdoor play area. The new outdoor area contains a total of 19998.92 square feet which combined with the previous playground area will accommodate the increased capacity. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Report continued on LIC809-C..............
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CHARLES E. MACK PRESCHOOL
FACILITY NUMBER: 343601750
VISIT DATE: 10/16/2023
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An exit interview was conducted and in the areas that were evaluated, no deficiencies were observed at the time of the inspection.

Notice of Site was provided and LPAs advised Facility Representative it must remain posted for 30 days.

Prior to licensor the following must be completed:
1. A waiver submitted for sharing the outdoor playground.
2. Outdoor play structure age verification.

An exit interview was conducted and in the areas that were evaluated, no deficiencies were observed at the time of the inspection.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023
LIC809 (FAS) - (06/04)
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