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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621719
Report Date: 11/03/2023
Date Signed: 11/03/2023 11:56:07 AM

Document Has Been Signed on 11/03/2023 11:56 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:VINELAND PRESCHOOLFACILITY NUMBER:
343621719
ADMINISTRATOR:NICOLE SCHLIEFACILITY TYPE:
850
ADDRESS:6450 20TH STREETTELEPHONE:
(916) 566-1616
CITY:RIO LINDASTATE: CAZIP CODE:
95673
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 9DATE:
11/03/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Amanda AllensworthTIME COMPLETED:
12:15 PM
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On 11/3/2023, Licensing Program Analysts (LPAs) Amanda Sutter and Kyrsten Williams arrived at the facility for the purpose of an unannounced case management inspection. LPAs conducted interviews for an incident unrelated to this facility. Upon arrival, LPAs observed 9 children supervised by 3 staff.

Based on the inspection, no citations have been issued. Exit interview conducted and report was reviewed with the Site Supervisor Amanda Allensworth.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2023
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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