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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343602532
Report Date: 10/20/2023
Date Signed: 10/20/2023 11:13:40 AM

Document Has Been Signed on 10/20/2023 11:13 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:FAIRSITE PRESCHOOLFACILITY NUMBER:
343602532
ADMINISTRATOR:DUBOIS, KATIEFACILITY TYPE:
850
ADDRESS:902 CAROLINE AVENUETELEPHONE:
(209) 745-2506
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: 93DATE:
10/20/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kuljeet Nijjar TIME COMPLETED:
11:30 AM
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On 10/20/2023, Licensing Program Analyst Katy Velazquez (LPA) conducted a field visit to the facility for the purpose of a case management inspection regarding a Plan of Correction. LPA arrived at the facility and was met by Program Representative Kuljeet Nijjar (D1). LPA disclosed the purpose of the inspection and was granted entrance into the facility. Criminal record clearances are on file with Galt Joint Union District. D1 was reminded that all adults 18 and over, 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.

LPA conducted a tour of the facility and observed 93 preschool aged children in attendance. Staff members were aware of classroom(s) head count and record review showed that all children in attendance were signed-in. LPA cleared the Type-A citation dated 10/05/2023.

No citations were issued in the areas that were observed on 10/20/2023. An exit interview was conducted, and the report was reviewed with D1. LPA provided D1 with Licensee Appeal Rights. A Notice of Site visit was posted by LPA and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2023
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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