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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313621973
Report Date: 09/23/2024
Date Signed: 09/23/2024 10:55:25 AM

Document Has Been Signed on 09/23/2024 10:55 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ADVENTURE CHRISTIAN SCHOOL (PS)FACILITY NUMBER:
313621973
ADMINISTRATOR/
DIRECTOR:		WILLIAMS, PAULAFACILITY TYPE:
850
ADDRESS:6401 STANFORD RANCH ROADTELEPHONE:
(916) 781-2986
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 256TOTAL ENROLLED CHILDREN: 256CENSUS: 142DATE:
09/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Paula Williams - DirectorTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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An unannounced inspection was conducted today by Licensing Program Analyst Owens and McClain, LPA's met with Director, Paula Williams. Present at time of inspection were 142 preschool children and 16 staff.

The purpose of the inspection is to discuss an unusual incident report that was self reported to Licensing. The incident occurred on September 18, 2924. A child was climbing on the climbing dome on the preschool playground. The child was on the inside of the dome hanging by their hands when the child let go and fell. The child landed on their right leg in the tan bark causing injury to the leg. Child received medical treatment. Staff was present and in ratio.

LPA's observed the playground where the incident took place and the playground has sufficient cushioning of wood chips.

No deficiencies issued.
SUPERVISORS NAME: Jennifer Brekke
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2024
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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