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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 090309074
Report Date: 07/31/2024
Date Signed: 07/31/2024 04:41:21 PM

Document Has Been Signed on 07/31/2024 04:41 PM - 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:GEORGETOWN HEAD STARTFACILITY NUMBER:
090309074
ADMINISTRATOR/
DIRECTOR:		ENGLISH, MARIAFACILITY TYPE:
850
ADDRESS:6530 HARKNESS STREETTELEPHONE:
(530) 295-4515
CITY:GEORGETOWNSTATE: CAZIP CODE:
95634
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 0DATE:
07/31/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Colleen BraunbeckTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 7/31/2024 at approximately 10:00am, Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Arianna Manabat met with Licensee Representative Colleen Braunbeck for the purpose of an announced change of capacity case management inspection. During today's visit LPA Manabat measured the outdoor play area and discussed removing the Head Start portable from the license.

During the discussion, LPA Manabat and the Applicant confirmed that the head start portable is no longer in use by the preschool program. This limits the total square footage to 720.19 sqft with 2 toilets and 3 sinks. There is a separate staff restroom inside of portable 500 room that is labeled as adult bathroom.

OUTDOOR ACTIVITY SPACE:
There is currently one outdoor areas on site that is intended for use by the facility. During today's visit, LPA Manabat measured a total of 2706.73 sqft which will accommodate the applicants request for 20 preschool children. All areas of the facility have remained the same since the case management inspection on 07/26/2024.

An exit interview was conducted and the report was reviewed with the facility representative.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
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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