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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621948
Report Date: 11/06/2019
Date Signed: 11/06/2019 02:51:24 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:ZEHNDER RANCH SCHOOL AGE PROGRAMFACILITY NUMBER:
343621948
ADMINISTRATOR:DE LA CRUZ, JACKIELYNFACILITY TYPE:
840
ADDRESS:9880 DENALI CIRCLETELEPHONE:
(916) 286-7865
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY:70CENSUS: 28DATE:
11/06/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Tiffany WilliamsonTIME COMPLETED:
03:05 PM
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Licensing Program Analyst (LPA) Fabiola Diaz and LPM Jeanne Smith met with director Tiffany Williamson to follow up on a Plan of Correction (POC) from 6/11/2019. Director has implemented a plan to track the number of children being brought back from their classrooms to the after school program by counting the children at pick up time, as they walk back to the program, and once reached at the program. Director stated constant and adequate supervision is being provided. Substitutes will also be informed of the procedures for keeping track of children at the facility. There has not been any subsequent incidents of children left unaccounted for.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola DiazTELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019
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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