573616558-12-14-2023-53-CC-ASIS-CYHR6C-20231214114430

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 573616558
Report Date: 12/14/2023
Date Signed: 12/14/2023 11:44:34 AM

Document Has Been Signed on 12/14/2023 11:44 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	WOODLAND JOINT USD-PRAIRIE		FACILITY NUMBER:	573616558
ADMINISTRATOR:	TAPIA, MARIA		FACILITY TYPE:	850
ADDRESS:	1444 STETSON STREET		TELEPHONE:	(530) 406-2623
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95776
CAPACITY:	93	CENSUS: 48	DATE:	12/14/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Maria Lewis		TIME COMPLETED:	10:45 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	Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Licensee Representative, Maria Lewis for the purpose of a case management inspection. Licensee Representative requests a decrease change of capacity due to only occupying three classrooms for the preschool program. The fire clearance (STD850) was granted and received on 11/3/2023. The program currently operates Monday through Friday from 7:00 a.m. to 6:00 p.m. INDOOR ACTIVITY SPACE: There are three preschool classrooms, room H1, I1, and I2. LPA measured the three classrooms. The total classroom spaces contain a total of 2,571 square feet, which will accommodate Licensee’s request for 72 preschool children. There are four toilets and seven sinks for the children. There are two staff restrooms located in room H1 and I1 labeled staff restroom. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). OUTDOOR ACTIVITY SPACE: LPA asked Licensee Representative if any changes have been made with the outdoor space. Licensee Representative states no. LPA observed current outdoor measurements from report dated 8/16/2013 for a total of 4,112 square feet which will only accommodate up to 54 preschool children. LPA did not observe an Insufficient Outdoor Space Waiver on file. LPA informed Licensee Representative that LPA will provide the facility with the waiver to print and post next to the license. Report continues on LIC809-C.

SUPERVISOR'S NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: 916-917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: WOODLAND JOINT USD-PRAIRIE	FACILITY NUMBER: 573616558
	VISIT DATE: 12/14/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over, 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.

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.

Exit interview conducted and report was reviewed with the Licensee Representative, Maria Lewis.

Effective today, 12/14/2023, LPA will approve the change of capacity for 72 preschool children.

SUPERVISOR'S NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: 916-917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC809 (FAS) - (06/04)

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