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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615108
Report Date: 12/11/2023
Date Signed: 12/11/2023 09:56:47 AM

Document Has Been Signed on 12/11/2023 09:56 AM - 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:WOODRIDGE PRESCHOOL CENTERFACILITY NUMBER:
343615108
ADMINISTRATOR:MAI VANGFACILITY TYPE:
850
ADDRESS:5950 REVELSTOK DRIVETELEPHONE:
(916) 566-1650
CITY:SACRAMENTOSTATE: CAZIP CODE:
95842
CAPACITY: 94TOTAL ENROLLED CHILDREN: 94CENSUS: 55DATE:
12/11/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Mai VangTIME COMPLETED:
10:00 AM
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On December 11, 2023, Licensing Program Analyst (LPA) Amanda Sutter met with Director Mai Vang for a case management inspection to discuss the unusual incident report (UIR) that was reported and submitted on July 10, 2023. LPA observed fifty-five children supervised by 12 staff.

The incident that occurred involved staff and students from another preschool program. LPA conducted collateral visits over the course of the investigation.

No deficiencies were cited in today’s visit.

Exit interview was conducted with Mai Vang and notice of site visit was posted.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/11/2023
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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