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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340321448
Report Date: 01/28/2026
Date Signed: 01/28/2026 02:51:31 PM

Document Has Been Signed on 01/28/2026 02:51 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:ROBLA PRESCHOOLFACILITY NUMBER:
340321448
ADMINISTRATOR/
DIRECTOR:		FABIOLA SALCEDAFACILITY TYPE:
850
ADDRESS:4351 PINELL STREETTELEPHONE:
(916) 927-0136
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY: 198TOTAL ENROLLED CHILDREN: 133CENSUS: 65DATE:
01/28/2026
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Fabiola Salceda TIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
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On January 28th, 2026, at approximately 9:15 AM Licensing Program Analyst (LPA) Pa Dao Vang met with Director Fabiola Salceda to conduct an unannounced case management inspection. During today’s inspection there were 65 children supervised by 26 staff.

On December 17, 2025, the facility submitted a LIC624 Unusual Injury Report to the LPA regarding an absence of supervision. It was indicated that C1 was left alone in Classroom 13 as the children and staff were outside. LPA conducted three staff interviews regarding the incident. LPA learned that there were several transitions from Room 2 into Classroom 13 and to the play structure at 9:45 AM. When they got outside, S1 and S2 were supervising the children as S4 left the facility. After approximately 8 minutes, S1 noticed that C1 was missing from the group. S3 was on her break and walked through the classroom, when she found C1 playing in the circle area alone. She then took C1 to join the rest of the classroom outside. According to the Director, they have conducted a staff training, met with the parent, implemented supervision, and transition strategies with the staff and children. The Plan of Correction is also cleared today.

On October 30, 2025, the facility completed a Lead Testing with three outlets samples with Action Level Exceedence. There was the Back Flow with 150 ppb, Room 1 with 15 ppb, and Room 2 with 5.5 ppb. The Back Flow is located outside of the facility building next to the fire hydrant in the parking lot. In Room #1, LPA observed room two sinks in the hallway labeled with signs for no usage. LPA also observed another sink with a drinking fountain with no label. The Director stated that there are no children enrolled in Room 1 and Room 2 currently. The Director will put another signs for no usage on the sinks and drinking fountains in Room 1 and 2.

Continue on LIC809-C...

NAME OF LICENSING PROGRAM MANAGER: Seychelle De Luca
NAME OF LICENSING PROGRAM ANALYST: Dao Vang
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ROBLA PRESCHOOL
FACILITY NUMBER: 340321448
VISIT DATE: 01/28/2026
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On January 20, 2026, the facility retest the drinking fountain in Room 1 twice. The results show Sample 1 with 9.9 ppb and LCS with 93.3 ppb. The construction team retested Room 2 sink and fountain. The Director will obtain the results and email a copy to LPA. The facility map did not show where the retesting was located on the premises. LPA obtained a copy of the retest report. The Director will consult with the admin team about the Plan of Correction and will also email LPA. LPA discussed submitting required documents (LIC 9275 External Water Sampler Self-Certification Form and LIC 9276 Child Care Center Sampling Checklist Form) to LPA’s email.

The deficiencies are cited on the following LIC809-D page, and the plan of corrections were reviewed with Director Fabiola Salceda. The Director acknowledges, that for TYPE A DEFICIENCIES ONLY upon receipt, facility shall post LIC 9099-D with Type A deficiency for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the License. An exit interview was conducted, a copy of this report, LIC9224, Notice of Site Visit, and Appeal Rights were also provided to Director Fabiola Salceda. The Notice of Site Visit shall be posted for 30 consecutive days. Failure to comply with posting requirements can result in a $100 penalty.

NAME OF LICENSING PROGRAM MANAGER: Seychelle De Luca
NAME OF LICENSING PROGRAM ANALYST: Dao Vang
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 01/28/2026 02:51 PM - It Cannot Be Edited


Created By: Dao Vang On 01/28/2026 at 01:27 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ROBLA PRESCHOOL
FACILITY NUMBER: 340321448

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/29/2026
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision
(1) No child(ren) shall be left without the supervison of a teacher at any time,...Supervision shall include visual observation.
This requirement is not met as evidenced by:
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The facility have conducted a staff training, met with the parent, implemented supervision, and transition strategies with the children.
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Based on interviews, LPA learened that C1 was left alone in Classroom 13 for approximately 8 minutes with an absence of supervision. This poses an immediate health, safety or personal rights risk to persons in care.
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Type B
02/28/2026
Section Cited
101700.3(b)(1)

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California Lead Action Level at Child Care Centers (b) Testing results with ... (1) A ... values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidenced by:
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Director will met with District team to impletment a plan of correction and will email me.
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Based on record review, there are two water outlet retested exceeded the allowed 5.5 ppb, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Seychelle De Luca
NAME OF LICENSING PROGRAM MANAGER:
Dao Vang
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/28/2026


LIC809 (FAS) - (06/04)
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