<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500782
Report Date: 08/24/2023
Date Signed: 08/24/2023 11:07:35 AM

Document Has Been Signed on 08/24/2023 11:07 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:PEREGRINE SCHOOLFACILITY NUMBER:
574500782
ADMINISTRATOR:CORTEZ, GABRIELAFACILITY TYPE:
830
ADDRESS:2650 LILLARD DRIVETELEPHONE:
(530) 753-5500
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 0DATE:
08/24/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Gabriela CortezTIME COMPLETED:
11:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Application Specialist (AS) Alecia Sifuentes met with Licensee Representative/Director Gabriela Valenzuela Cortez for the purpose of a prelicensing inspection continuation. Applicant requests an infant license to serve 15 children from 12-24 months. The program will operate Monday through Friday from 7:30 a.m. to 5:30 p.m. Parents will provide meals, snacks, formula, breast milk, and baby food for their children.

INDOOR ACTIVITY SPACE:
There is one infant classroom located in room #6. AS observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and 15 napping cots. Facility only plans to care for children 12-24 months. Director acknowledges there will be no infants under 12 months old due to no available cribs and crib area. Director understands that if they would like to change the age range to 0-24 months then a new application (LIC200A), supporting documents, crib area or crib room, updated fire inspection request (STD850), and a case management inspection will be needed prior to approval.

AS used current measurements from report dated 3/6/2023 therefore AS did not take measurements. The total classroom space contains a total of 630 square feet, which will accommodate applicants request for 15 infants. There is one sink in the classroom for the children. AS observed a changing table/area within arm's reach of the sink.

OUTDOOR ACTIVITY SPACE:
There is one infant outdoor area on the property. AS observed that the outdoor area is still under construction. Director stated that the outdoor area should be completed by by 8/28/2023. Director will provide photos to AS once completed. If needed the Director stated that in the infants can utilize the toddler outdoor activity space when not in use by the toddlers.

Report continues on LIC809-C.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2023
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: PEREGRINE SCHOOL
FACILITY NUMBER: 574500782
VISIT DATE: 08/24/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Director has requested a Shared Outdoor Space Waiver to allow the preschool children to utilize the infant outdoor space. The outdoor play area is fenced with a wrought iron fence that is at least four feet tall. There is no play structure. AS observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by overhangs, rolling shades, and a seasonal canopy.

AS measured the outdoor area. The outdoor area contains a total of 1,720 square feet, which will accommodate applicant’s request for 15 infants.

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Director was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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

Effective today, 8/24/2023, AS will grant the license to serve children from age 0-24 months (with a maximum census of 0 infants under 12 months old due to no available cribs).
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2