054500738-1-12-2023-53-CC-ASIS-CMZNMG-20230112093507

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 054500738
Report Date: 01/12/2023
Date Signed: 01/12/2023 09:36:40 AM

Document Has Been Signed on 01/12/2023 09:36 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	SARAH KELLY'S CHILD CARE & LEARNING CENTER		FACILITY NUMBER:	054500738
ADMINISTRATOR:	SAMANTHA ARTIAGA		FACILITY TYPE:	850
ADDRESS:	4423 SIX MILE ROAD		TELEPHONE:	(209) 263-2295
CITY:	ANGELS CAMP	STATE: CA	ZIP CODE:	95222
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 11	DATE:	01/12/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Sarah Kelly		TIME COMPLETED:	10:15 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 met with Licensee, Sarah Kelly for the purpose of a change of capacity case management inspection. Licensee requests a preschool license to serve 24 preschool children from age two to entry into kindergarten. The program operates Monday through Friday from 7:00 a.m. to 6:00 p.m. INDOOR ACTIVITY SPACE: There are four preschool classrooms. Licensee has converted the staff room into the fourth preschool classroom. AS observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. AS measured four classrooms. The total classroom space contains a total of 851 square feet, which will accommodate Licensee's request for 24 preschool children. There are 3 toilets and 4 sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). OUTDOOR ACTIVITY SPACE: There is one outdoor area on the property that is shared with the school-age children. Licensee has posted the Shared Outdoor Space Waiver. AS used current outdoor measurements. The outdoor play area contains a total of 7,254 square feet, which will accommodate Licensee’s request for 24 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Report continues on LIC809-C.

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: SARAH KELLY'S CHILD CARE & LEARNING CENTER	FACILITY NUMBER: 054500738
	VISIT DATE: 01/12/2023

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Applicant 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.

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 Licensee, Sarah Kelly.

The following item is required before a change of capacity will be approved:
1. Updated granted fire clearance (STD850)

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC809 (FAS) - (06/04)

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