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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313625035
Report Date: 08/12/2024
Date Signed: 08/12/2024 01:27:11 PM

Document Has Been Signed on 08/12/2024 01:27 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:STAR RIDGEVIEWFACILITY NUMBER:
313625035
ADMINISTRATOR/
DIRECTOR:		TIM WILLIAMSONFACILITY TYPE:
840
ADDRESS:9177 TWIN SCHOOLS ROADTELEPHONE:
(916) 632-8407
CITY:GRANITE BAYSTATE: CAZIP CODE:
95746
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 0DATE:
08/12/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:55 PM
MET WITH:Tim WilliamsonTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Jeremey McClain met with licensing representative Tim Williamson for the purpose of an unannounced Case Management inspection. The program is requesting to move to room 600. The facility is located on the Greenhills Elementary Campus. The facility will be utilizing classroom 600 and the gymnasium. No changes will be made to the program's capacity, the restrooms, or the playground areas. The fire clearance was granted on 08/12/2024.

The program hours of operation are Monday through Friday from 3:30 pm to 6:00 pm.

LPA inspected Classroom A2. LPA observed sufficient child size tables, chairs, and storage. LPA observed a variety of age-appropriate equipment. A first-aid kit is available. Licensing representative stated medications and cleaning disinfectants will be stored in the classroom inaccessible to children. LPA did not observe any poisons or firearms on the premises. LPAs observed a functional carbon monoxide detector in the classroom. A water fountain and faucet combo is available in the classroom, however, licensing representative understands that water from this source shall not be used until proof of lead testing has been provided. Facility has a designated space for isolation in the event a child becomes sick while in care.

Per Health and Safety Code1596.806 Exemption from square footage, toilet, isolation space, outdoor activity space, and fencing requirements, LPA did not measure the indoor and outdoor activity space.


As of today, room 600 is approved for usage. Exit interview conducted and report was reviewed with licensing representative Tim Williamson.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2024
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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