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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615514
Report Date: 01/07/2020
Date Signed: 01/07/2020 12:18:15 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:ST. CHARLES BORROMEO SCHOOL PRE-KFACILITY NUMBER:
343615514
ADMINISTRATOR:LEAH QUACKENBUSHFACILITY TYPE:
850
ADDRESS:7580 CENTER PARKWAYTELEPHONE:
(916) 421-6189
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:30CENSUS: 0DATE:
01/07/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Leah QuackenbushTIME COMPLETED:
12:35 PM
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Licensing Program Analyst (LPA), Elvira sierra conducted a POC (Plan of Corrections) inspection and met with Director, Leah Quackenbush . There were no children present in the facility. Purpose of the inspection was explained and was to verify the correction of citations issued on 10/24/19. LPA reviewed staff files and observed documentation for educational background and current immunization on record.

Based upon today’s inspection, LPA observed deficiencies are clear and corrected as of today.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the director and provided copies. An exist interview was conducted. LPA observed the Notice of Site Visit posted and the director understands it must remain posted for 30 days.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020
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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