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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 034500943
Report Date: 08/06/2024
Date Signed: 08/06/2024 10:16:58 AM

Document Has Been Signed on 08/06/2024 10:16 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:GOLD STAR PRESCHOOLFACILITY NUMBER:
034500943
ADMINISTRATOR/
DIRECTOR:		LOFFSWOLD, MICHELLEFACILITY TYPE:
850
ADDRESS:190 FOGARTY RDTELEPHONE:
(209) 256-8059
CITY:SUTTER CREEKSTATE: CAZIP CODE:
95685
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 23DATE:
08/06/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Director, Michelle LoffswoldTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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On August 6, 2024, Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes and Licensing Program Analyst (LPA) Elizabeth Santiago met with Director Michelle Loffswold for the purpose of a case management inspection. Licensee request to add a second outdoor activity space. Licensee is not making any changes to license capacity. The program currently operates Monday through Friday from 7:30 A.M. to 5:30 P.M.

OUTDOOR ACTIVITY SPACE:
There is two preschool outdoor areas on the property. LPA used current measurements from report dated 9/28/2023 therefore LPA did not measure the back yard playground. LPA measured the side yard. The total outdoor activity spaces contains a total of 3,616 square feet which will accommodate director's current licensed capacity of 30 preschool children. LPA observed and insufficient outdoor space waiver on file, LPA informed director that the waiver is no longer needed due to additional outdoor square footage added. 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, Michelle.
Effective today, 8/6/2024, LPA will approve the additional outdoor space.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Elizabeth Santiago
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2024
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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