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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343616158
Report Date: 11/30/2021
Date Signed: 11/30/2021 12:11:52 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:SACRAMENTO ADVENTIST ACADEMYFACILITY NUMBER:
343616158
ADMINISTRATOR:SHARI THOMPSONFACILITY TYPE:
850
ADDRESS:5601 WINDING WAYTELEPHONE:
(916) 481-2300
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:24CENSUS: DATE:
11/30/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Cathlean RipleyTIME COMPLETED:
12:30 PM
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At 11:00 a.m. on Tuesday, November 30th, 2021, Licensing Program Analyst (LPA) Karyn Guerra met with Staff, Cathlean Ripley, for the purpose of a case management inspection. A risk assessment for COVID-19 was conducted prior to entry. Upon arrival, LPA observed a census of 22 preschool children supervised by 3 staff. All individuals subject to criminal background review have obtained criminal record clearance.

The facility wishes to add a room and increase the capacity from 24 to 48 preschool children. An approved fire clearance for the capacity increase has been received and is on file with the department. Facility has 4 total toilets and 7 total sinks. The previously licensed preschool classroom was measured during the pre-licensing inspection and none of the other usable space within the facility has changed since licensure.

Indoor Activity Space


The indoor play space was measured. Total square footage of the indoor play space in the new classroom measures 974 square feet. The indoor square footage will accommodate the requested increase in capacity of 24 children.

Outdoor Activity Space
The outdoor play area is fenced and shade is provided. The outdoor activity space was previously measured during a prelicensing inspection and has not changed.

Effective today, Tuesday, November 30th, 2021, LPA Guerra is granting a capacity increase for up to 48 preschool aged children.

There were no deficiencies cited during today's visit. An exit interview was conducted. Notice of Site Visit provided and shall remain posted for 30 days.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2021
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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