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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343606960
Report Date: 07/25/2024
Date Signed: 07/25/2024 11:50:16 AM

Document Has Been Signed on 07/25/2024 11:50 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:4TH R - TWO RIVERSFACILITY NUMBER:
343606960
ADMINISTRATOR/
DIRECTOR:		JEANINNIE SELFFACILITY TYPE:
840
ADDRESS:3201 WEST RIVER DRIVETELEPHONE:
(916) 277-3849
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 33DATE:
07/25/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Tammy O'CallaghanTIME VISIT/
INSPECTION COMPLETED:
12:05 PM
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On 7/25/2023 at approximately 11:15am, Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Arianna Manabat met with Program Coordinator Tammy O'Callaghan for the purpose of an unannounced change of capacity case management inspection. The Licensee requests a total of 150 school-age children ages Enrolled in Transitional Kindergarten to 5th grade. The fire clearance was received and granted on 04/24/2024. The programs Facility hours of operation are 7:00AM-6:00PM during the summer Monday through Friday 7:00 AM - 7:35 AM (Morning Time) to 1:55PM - 6:00PM for 1ST-5TH GRADE and 1:38 PM-6:00PM for TK- KINDER.

INDOOR ACTIVITY SPACE:
The program is located on an elementary school site and utilize portables, #P1, #P2, #E13, #C3, and #E3 to operate. During today's visit, LPAs observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and physical plant requirements for school-age programs. CAB LPA did not measure the indoor space as per Title 22 regulation Indoor Activity Space for School-Age Children 101538.3(c) which states that School-age child care programs that meet the requirements of Health and Safety Code Section 1596.806 are exempt from square-footage requirements for indoor activity space.

OUTDOOR ACTIVITY SPACE:
During today's visit LPA Manabat observed a sufficient amount of equipment and toys available for use. LPA Manabat did not measure the outdoor space as per Title 22 regulation 101538.2 (c) for Outdoor Activity Space for School-Age Children states that School-age child care programs that meet the requirements of Health and Safety Code Section 1596.806 are exempt from square-footage requirements for outdoor activity space. The children do utilize all outdoor play areas that are available on the school site. Water is provided via water bottles, drinking fountains, and filtered water machine.
Report continues on LIC809-C....
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2024
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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: 4TH R - TWO RIVERS
FACILITY NUMBER: 343606960
VISIT DATE: 07/25/2024
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Facility Representative stated there are no firearms, weapons, or bodies of water on the facility premises. There are shaded areas supplied by trees and overhangs

Licensee Representative 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.

Prior to issuing a license, the following conditions must be submitted:

1. Pending Licensing Program Manager's final review.
Exit interview conducted and report was reviewed with the Licensee Representative.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024
LIC809 (FAS) - (06/04)
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