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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393608039
Report Date: 04/27/2021
Date Signed: 04/27/2021 11:04:51 AM

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. PETER'S PRESCHOOLFACILITY NUMBER:
393608039
ADMINISTRATOR:HUST, JANFACILITY TYPE:
850
ADDRESS:50 S. LOWER SACRAMENTO RDTELEPHONE:
(209) 368-5929
CITY:LODISTATE: CAZIP CODE:
95242
CAPACITY:72CENSUS: 63DATE:
04/27/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Dale Munsch and Jan HustTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Justin Denton met with Director Jan Hust and Principal Dale Munsch for the purpose of a case management inspection. This inspection was conducted over video-chat due to the COVID-19 pandemic.

LPA observed the new playground equipment for the preschool-age children to be installed according to manufacturer instructions. Munsch and Hust stated that the playground will be exclusively for the preschool. There is a fence separating it from the playground for the school age children. LPA observed a sticker on the equipment stating that it is designed for children 2-5 and 5-12. LPA observed a shock-absorbing surfaced installed underneath the playground equipment.

LPA will check the playground in person during his next on-site visit.

No deficiencies were cited at this time.

A copy of this report was provided to the facility by email. Hust agreed to sign and return the report.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Justin L DentonTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021
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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