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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573619923
Report Date: 12/19/2024
Date Signed: 12/19/2024 12:12:16 PM

Document Has Been Signed on 12/19/2024 12:12 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:PEREGRINE SCHOOLFACILITY NUMBER:
573619923
ADMINISTRATOR/
DIRECTOR:
GABRIELA CORTEZFACILITY TYPE:
850
ADDRESS:2650 LILLARD DRIVETELEPHONE:
(530) 753-5500
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 41DATE:
12/19/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Gabriela CortezTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Director/Licensee Representative Gabriela Valenzuela Cortez for the purpose of a case management inspection. Licensee requests a room change for the preschool program. Licensee is removing Room #5 from the preschool program and adding the multipurpose room (MPR). Licensee is not making any changes to the licensed capacity. The program currently operates Monday through Friday from 7:30 a.m. to 5:30 p.m.

INDOOR ACTIVITY SPACE:
There is one toddler classroom located in Room #1 and five preschool classrooms located in Room #1A, #2, #3, #4, and MPR. LPA used current measurements from report dated 8/23/2024, therefore LPA did not take measurements for Rooms #1, #1A, #2, #3, and #4. LPA measured the MPR. The total classroom spaces contain a total of 3,254 square feet, which will accommodate Licensee’s current capacity of 12 toddlers and 78 preschool children. There is ten sinks and six toilets for the children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Director 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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Gabriela Valenzuela Cortez.

Effective today, 12/19/2024, LPA will approved the room change.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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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