573600895-8-8-2022-53-CC-ASIS-CH4NCG-20220808102042

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 573600895
Report Date: 08/08/2022
Date Signed: 08/08/2022 10:20:48 AM

Document Has Been Signed on 08/08/2022 10:20 AM - It Cannot Be Edited

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. JOHN'S PRESCHOOL & CHILDCARE CENTER		FACILITY NUMBER:	573600895
ADMINISTRATOR:	SHILOH BEARD		FACILITY TYPE:	850
ADDRESS:	434 CLEVELAND STREET		TELEPHONE:	(530) 662-0764
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95695
CAPACITY:	72	CENSUS: 35	DATE:	08/08/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Shiloh Beard		TIME COMPLETED:	10:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Application Specialist (AS) Alecia Sifuentes and Licensing Program Analyst (LPA) Chayntel Hunter met with Director, Shiloh Beard for the purpose of an announced change of capacity case management inspection. Licensee requests to serve 88 preschool children from 2 years to entry into first grade and remove the toddler option of 12 toddler children. The program operates Monday through Friday from 7:30 a.m. to 5:00 p.m. The fire clearance was granted and received on 7/26/2022. INDOOR ACTIVITY SPACE: There are six preschool classrooms. AS observed a sufficient amount of equipment, toys, tables, chairs, nap mats, and cubbies. AS remeasured all six classrooms. The total classroom space contains a total of 2,687 square feet, which will only accommodate 76 preschool children. There are 5 toilets and 7 sinks for the children. AS informed Director that the max capacity can only be 75 due to the available toilets. There is a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). OUTDOOR ACTIVITY SPACE: There are two outdoor areas on the property. AS used current outdoor measurements. The outdoor play area contains a total of 13,403 square feet, which will accommodate 75 preschool children. Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Report continues on LIC809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: ST. JOHN'S PRESCHOOL & CHILDCARE CENTER	FACILITY NUMBER: 573600895
	VISIT DATE: 08/08/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Director, Shiloh Beard. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

The following items are required before approve of the change of capacity:
1. Updated granted fire clearance (STD850).

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2