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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343611329
Report Date: 05/31/2019
Date Signed: 05/31/2019 12:24:36 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:RIVER CITY CHRISTIAN PRESCHOOLFACILITY NUMBER:
343611329
ADMINISTRATOR:JESKE, DAWN LARSONFACILITY TYPE:
850
ADDRESS:10933 PROGRESS COURTTELEPHONE:
(916) 861-1625
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY:68CENSUS: 0DATE:
05/31/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Dawn Larson JeskeTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA), Jan Hoshida, met with director, Dawn Larson Jeske, for the purpose of conducting a case management inspection to discuss the unusual incident report (UIR) that the program submitted on 5/20/2019. LPA observed there were no children in care today due to the center being closed for cleaning week.

LPA interviewed the Director and observed classrooms.

No deficiencies were cited in today’s visit.

Exit interview and notice of site visit was posted.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019
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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