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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620030
Report Date: 02/24/2023
Date Signed: 02/24/2023 01:29:53 PM

Document Has Been Signed on 02/24/2023 01:29 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:PLAY-OLOGYFACILITY NUMBER:
343620030
ADMINISTRATOR:VANCE, JENNIFERFACILITY TYPE:
850
ADDRESS:3084 SUNRISE BLVD STE 4TELEPHONE:
(916) 853-5678
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95742
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 45DATE:
02/24/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Jennfier VanceTIME COMPLETED:
01:45 PM
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Licensing Program Manger (LPM) and Licensing Program Analyst Erwina Pascual-Golamco (LPA) came in for an unannounced case management visit for a change of capacity.

The center has requested an increase of capacity, from 60 children to 75 children. There were two sinks and a toilet were added to accommodate the increase.

During today's visit, LPAs observed 3162 square feet, which will accommodate the requested 75 children. The outside play area measured 3367 square feet on a change of capacity visit on 12/21/15. A waiver was requested for 44 children and will still be in effect.

Prior to licensure, the following must be obtained:

1. A fire clearance (STD 850) must be received by the Licensing Agency
2. A new waiver for outside play space must be issued. This is the responsibility of the Licensing Agency and the updated waiver will be included with the new updated license.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2023
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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