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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343614546
Report Date: 08/25/2020
Date Signed: 08/25/2020 03:48:50 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:SHALOM PRESCHOOLFACILITY NUMBER:
343614546
ADMINISTRATOR:LAURA HALENFACILITY TYPE:
830
ADDRESS:2320 SIERRA BLVD.TELEPHONE:
(916) 485-4151
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:34CENSUS: 8DATE:
08/25/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Laura HalenTIME COMPLETED:
12:50 PM
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On August 6, 2020 at approximately 11:00 AM Licensing Program Analyst (LPA) Elvira Sierra conducted a Case Management tele-inspection with Director, Laura Halen for the purpose of decreasing capacity from 34 to 16 children. The inspection was conducted via Face-time due to COVID-19 pandemic and California State of Emergency Shelter in Place orders.

Facility operates inside Shalom School Campus; M-F from 07:30 AM to 06:00 PM year-round. Director stated that facility temporary changed the hours of operation due to COVID-19 Pandemic; M-F from 07:45 AM to 03:30 PM. Infant license will operate in Keshet classroom.

A virtual health and safety inspection was conducted in all areas accessible to children. The room is currently equipped with infant-size furnishings. There is sufficient space for storing infant's personal belongings. There is a kitchen to support the food service.There is a changing table within arms reach of a sink. There is a separate staff restroom. Children who become ill during the day will be isolated in the office and will use the staff restroom if necessary. There 3 sinks in the classroom. Per Director facility is only enrolling children that can move and are not required a crib to sleep. Director stated that facility is only receiving children that are over the age of 12 months.

Director measured infant classroom and LPA walked her through the measuring process. The classroom activity area contains a total of 747.92 square feet, which will accommodate the request capacity for 16 infants. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

A fire clearance was granted and approved on 08/18/20.

In lieu of Director's signature, LPA is e-mailing the report with a read receipt request to Director. Notice of Site Visit was provided and should be posted in a conspicuous area for 30 days. No Title 22 deficiencies are cited during the tele-visit.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2020
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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