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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343604900
Report Date: 07/18/2019
Date Signed: 07/18/2019 11:11:32 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:4TH R - PHOEBE HEARSTFACILITY NUMBER:
343604900
ADMINISTRATOR:NOLLER, CHIRSTINEFACILITY TYPE:
840
ADDRESS:1410 60TH STREETTELEPHONE:
(916) 277-3840
CITY:SACRAMENTOSTATE: CAZIP CODE:
95819
CAPACITY:100CENSUS: 22DATE:
07/18/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Christine NollerTIME COMPLETED:
11:30 AM
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Licensing Program Analysts (LPAs) Marea Behvand and Seychelle De Luca met with Director Christine Noller for the purpose of an unannounced case management inspection. Licensee requested to increase from a capacity of 100 school age children to 150 school age children. Prior to today's inspection, LPA De Luca received the fire clearance.

A health and safety inspection was conducted in all areas accessible to children. LPAs measured four classrooms (Portable, MP, Library, and Room 26). The total indoor capacity square footage is 6022.06. This will accommodate Licensee's request for 150 school children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). The outdoor activity space was not measured due to facility being located on a school site.

Director was encouraged to visit the Department 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. The licensee's signature on this form acknowledges receipt of this form.

An exit interview was conducted and in the areas that were evaluated, no deficiencies were observed at the time of the inspection. A Notice of Site Visit was provided and should remain posted for 30 days for parental review.

Effective today 7/18/19 this facility is recommended for a license to serve 150 school age children.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea BehvandTELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019
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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