343614437-8-1-2019-03-CC-TWAN-BEMNQ8-20190801103930

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343614437
Report Date: 08/01/2019
Date Signed: 08/01/2019 10:39:38 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:	KOHLER PRESCHOOL		FACILITY NUMBER:	343614437
ADMINISTRATOR:	HUA LOR		FACILITY TYPE:	850
ADDRESS:	4004 BRUCE WAY		TELEPHONE:	(916) 566-1850
CITY:	NORTH HIGHLANDS	STATE: CA	ZIP CODE:	95660
CAPACITY:	48	CENSUS: 0	DATE:	08/01/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Lena Sounders and Elizabeth Cunnion		TIME COMPLETED:	10:45 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPAs) Tanya Washington and Seychelle De Luca met with Teacher on Special Assignment Lena Sounders and Licensee Representative Elizabeth Cunnion for the purpose of an announced case management inspection. Licensee requested to increase from a capacity of 48 pre-school age children to 72 pre-school age children. Facility is currently pending approval of the fire clearance for the additional room added (room #2). Facility will operate a part day program in the newly added room (room #2) from 8 AM to 11 AM and from 12 PM to 3 PM. Facility will operate a full day program in room #3 and #10 from 7 AM to 5 PM. A health and safety inspection was conducted in all areas accessible to children. LPAs measured all three classrooms, classrooms #3 and #10 are connected and classroom #2 is located across the way. The fenced outdoor area located next classroom #2 was also measured during the inspection. The total indoor capacity square footage for all three classrooms is 3,166.4 square feet. This will accommodate Licensee's request for 72 pre-school age children. The total outdoor measured space is 8,396.377 square feet. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). There are two toilets and two sinks in room #2 and two toilets and two sinks in room #3. Facility will request a waiver to use additional toilets and sinks located on the grounds of Kohler Elementary School. There is a play structure on the playground which is shared with the elementary school the safety label indicates age limitation for children ages 5 to 12 years old. Licensee acknowledges that children under 5 years old will not be able to use the play structure. Facility will also request a waiver for shared play yard use with the elementary school. Continued on LIC809C

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: KOHLER PRESCHOOL	FACILITY NUMBER: 343614437
	VISIT DATE: 08/01/2019

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Licensee Representative 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.

Upon receipt of fire clearance and approval of waiver requests, LPA will issue an updated license to reflect the capacity increase request.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

LIC809 (FAS) - (06/04)

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