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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615248
Report Date: 06/17/2024
Date Signed: 06/17/2024 01:53:08 PM

Document Has Been Signed on 06/17/2024 01:53 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ST. ELIZABETH ANN SETON PRESCHOOLFACILITY NUMBER:
343615248
ADMINISTRATOR/
DIRECTOR:		GREENE, MARCIAFACILITY TYPE:
850
ADDRESS:9539 RACQUET COURTTELEPHONE:
(916) 684-7903
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 1DATE:
06/17/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Tammy Babich TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 06/17/2024, Licensing Program Analyst Katy Velazquez (LPA1) and Centralized Application Bureau (CAB) Licensing Program Analyst Alecia Sifuentes (LPA2) conducted a Licensee initiated Case Management visit to inspect a newly remodeled playground with a new play structure. LPAs arrived at the facility and were met by Director Tammy Babich (D1). LPAs disclosed the purpose of the inspection and were granted entrance into the facility.

OUTDOOR ACTIVITY SPACE:
There is one playground on the property which is used for outdoor play. School Aged and Preschool Aged children both utilize this playground at different times of the day. A shared playground waiver is on file with the Department. LPAs did not observe any bodies of water on the premises. There were shaded areas supplied by a canopy, overhangs, and trees. The outdoor play area is fenced and equipped with children's outdoor play equipment. The outdoor activity space was measured. Measurements for outdoor area were 112124.98 square feet which will accommodate the current licensed capacity of 72 Preschool aged children. Individual measurements are recorded on the Capacity Worksheet LIC 9024. D1 stated that individual water bottles will be utilized for children when outside. LPAs inspected the new play structure which includes a safety label designating use for children 2 to 12 years old. LPAs observed a different safety label on the monkey bars (at the end of the play structure) which designates the monkey bars for children 5-12 years old. D1 was reminded that preschool aged children may NOT use the monkey bars. The manufacturer’s specifications designate the play dome for children ages 2 to 5 years old. The play structure is anchored and cushioned with poured in-place rubber.

Effective today, 06/17/2024, LPAs are approving the use of the playground and structure for preschool aged children (except the monkey bars). No deficiencies were cited today in the areas that were evaluated. An exit interview was conducted, and the report was reviewed with Director Babich. Licensee Appeal Rights were provided by LPA1. A Notice of Site visit was posted by LPA1 and must remain posted for 30 days. Failure to comply with posting requirements will result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 06/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2024
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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