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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093603209
Report Date: 01/23/2025
Date Signed: 01/23/2025 11:16:08 AM

Document Has Been Signed on 01/23/2025 11:16 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:PLACERVILLE PRESCHOOLERS/KID'S KAMPUSFACILITY NUMBER:
093603209
ADMINISTRATOR/
DIRECTOR:		BUENO, SHANONFACILITY TYPE:
850
ADDRESS:6556 COMMERCE WAYTELEPHONE:
(530) 626-2570
CITY:DIAMOND SPRINGSSTATE: CAZIP CODE:
95619
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 46DATE:
01/23/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Shanon BuenoTIME VISIT/
INSPECTION COMPLETED:
11:25 AM
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On January 23, 2025, Licensing Program Analyst (LPA) Soleil Marx and Regional Manager (RM) Natalie Dunaway, met with Facility Representative, Shanon Bueno, for the purpose of conducting an unannounced case management inspection. The purpose of today's inspection was explained.

Upon arrival, LPA observed a census of 46 preschool age children being supervised by eight staff. All individuals subject to criminal background review have obtained a clearance.

The purpose of today's inspection was to follow up on the physical plant of the lower yard/outdoor activity space and to provide technical assistance on facility administrative updates.

During today's inspection LPA and RM inspected the fencing in the lower yard which is only partially fenced. Per Title 22 regulation, Outdoor Activity Space 101238.2 (g)The playground shall be enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence shall be at least four feet high. Facility Representative stated the fencing material has been obtained and the new fencing will be installed and extended to make the outdoor activity space fully enclosed by February 24, 2025. Facility Representative will submit proof of fencing completed to LPA.

RM consulted with Facility Representative on updating administrative organization paperwork for the facility file, including board updates and a board resolution designating a Licensee Representative. Facility Representative will submit updated administrative paperwork to LPA Marx by February 24, 2025

Exit interview conducted and report reviewed with Facility Representative, Shanon Bueno. A notice of Site Visit was provided and must remain posted for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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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