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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500866
Report Date: 06/12/2023
Date Signed: 06/12/2023 11:29:14 AM

Document Has Been Signed on 06/12/2023 11:29 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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TREEHOUSE CHILDRENS CENTERFACILITY NUMBER:
574500866
ADMINISTRATOR:PECKHAM, JENNIFERFACILITY TYPE:
850
ADDRESS:418 HAVEN STTELEPHONE:
(916) 878-0585
CITY:WINTERSSTATE: CAZIP CODE:
95694
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 6DATE:
06/12/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Jennifer PeckhamTIME COMPLETED:
10:45 AM
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Application Specialist (AS) Alecia Sifuentes and Licensing Program Analyst (LPA) Jennie Tedlos met with Applicant Jennifer Peckham for the purpose of an announced second pre-licensing change of ownership inspection. Applicant requests a preschool license to serve 24 preschool children from age two to entry into kindergarten. The program will operate Monday through Friday from 8:30 a.m. to 2:30 p.m. The fire clearance was granted and received on 5/24/2023. The facility will provide morning and afternoon snacks.

INDOOR ACTIVITY SPACE:
There is one preschool classroom and art room. AS measured the classroom space. The total classroom space contains a total of 841 square feet, which will accommodate applicant's request for 24 preschool children. Applicant wants to also utilize the school-age classroom for the preschool children due the school-age program only operating during the summer. There is two toilets and two sinks for the children, and a separate private restroom for the staff. One toilet is located in the school-age classroom. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

Exit interview conducted and report was reviewed with the applicant Jennifer Peckham.

The following items are required before a license will be issued:
1. Remaining paperwork listed on LIC184
2. Final file review from Licensing Program Manager (LPM)
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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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