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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343614029
Report Date: 05/10/2023
Date Signed: 05/10/2023 12:47:40 PM

Document Has Been Signed on 05/10/2023 12:47 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:SMALLVILLE PRESCHOOLFACILITY NUMBER:
343614029
ADMINISTRATOR:NULL SHANNONFACILITY TYPE:
850
ADDRESS:4706 ARDEN WAYTELEPHONE:
(916) 480-0632
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 35DATE:
05/10/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Shannon NullTIME COMPLETED:
01:00 PM
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On Wednesday, May 10, 2023, at approximately 11:30 AM, Licensing Program Analyst (LPA) Josiah Gathing met with Licensee, Shannon Null, for the purpose of a case management, Licensee initiated inspection. LPA observed a census of 35 preschool children supervised by 8 staff. The facility requests to close the infant license and add the previous infant space to the total square footage for preschool license. Licensee is also requesting to increase the capacity to 72 preschool children from the previous capacity of 48.

INDOOR ACTIVITY SPACE:
A fire clearance was granted on March 29, 2023, and the fire marshal determined that the indoor space was sufficient to accommodate 75 children. The previous indoor preschool space of 1735.81 square feet was measured and documented on a capacity worksheet. The new space being added to the total square footage measures 901.37 square feet. Therefore, the total indoor classroom space measures 2,637.18 square feet and will accommodate the new requested capacity of 72 children. There are a total of 6 toilets and 6 sinks for the facility.

OUTDOOR ACTIVITY SPACE:
The outdoor space was previously measured and has not changed.

No deficiencies were cited during today's inspection. This report was reviewed with the Licensee and an exit interview was conducted. A notice of site visit was provided and shall remain posted for a period of 30 days for parental review.

Effective May 10, 2023, LPA will approve the facility for a capacity of 72 preschool children, licensed to serve children ages 2 to 5 years or entry into first grade.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
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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