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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313600445
Report Date: 12/04/2024
Date Signed: 12/04/2024 01:25:27 PM

Document Has Been Signed on 12/04/2024 01:25 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:GREENHILLS S.T.A.R.FACILITY NUMBER:
313600445
ADMINISTRATOR/
DIRECTOR:		RIDDLE, LISAFACILITY TYPE:
840
ADDRESS:8200 GREENHILLS WYTELEPHONE:
(916) 791-8448
CITY:GRANITE BAYSTATE: CAZIP CODE:
95746
CAPACITY: 300TOTAL ENROLLED CHILDREN: 300CENSUS: 103DATE:
12/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Lisa RiddleTIME VISIT/
INSPECTION COMPLETED:
01:40 PM
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Lisa Riddle for an unannounced Case Management Inspection regarding an Unusual Incident Report.

LPAs observed 103 children supervised by 12 staff members.

It was reported that on 11/20/24, 911 was called for emergency medical attention after a child was non-respondent while playing a game in the gymnasium. Staff attended to the child and tried to awaken them before their parents and the paramedics were called. During today’s inspection LPA reviewed the child's file, conducted interviews with staff.

An exit interview was conducted, and the report was reviewed with facility representative Lisa Riddle. A Notice of Site Visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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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