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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621616
Report Date: 09/24/2020
Date Signed: 09/24/2020 02:56:13 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:LIFE TIME ATHLETIC - FOLSOMFACILITY NUMBER:
343621616
ADMINISTRATOR:CATE, JENNIFERFACILITY TYPE:
840
ADDRESS:110 HEALTHY WAYTELEPHONE:
(916) 597-9100
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:150CENSUS: 12DATE:
09/24/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Jennifer CateTIME COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Kelly Ferrara contacted Director Jennifer Cate for a scheduled Case Management tele-inspection. The visit is being conducted via FaceTime due to the COVID19 pandemic. LPA verified there are currently 12 children present with three staff.

The facility is adding an additional room in the building for use by the program in order to have extra space. An updated facility sketch was submitted showing the new "Tween" room which is located next to the tennis office and close to the Activity Studio.

There are restrooms across the hall with enough stalls and sinks for children's use. The facility has a current waiver on file allowing children to have access to all restrooms on site. LPA reviewed the waiver to ensure the Director is following the conditions on the waiver. LPA observed that the room is furnished with a table and chairs, activities for children, and the room appears clean and ready for children's use. Chemicals are inaccessible to children yet close enough to keep the area clean.

LPA did not take measurements due to capacity remaining at 150 children. LPA received an approved fire clearance from the Folsom Fire Department.

Effective today, September 24th, 2020, the additional room is approved for childcare use.

LPA emailed the report to the Director. Notice of Site Visit was provided and should remain posted in for 30 days.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2020
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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