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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624247
Report Date: 08/02/2024
Date Signed: 08/02/2024 03:43:03 PM

Document Has Been Signed on 08/02/2024 03:43 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:EXCELSIOR PRESCHOOL GOLD RIVER LLCFACILITY NUMBER:
343624247
ADMINISTRATOR/
DIRECTOR:		FUGATE, NANCYFACILITY TYPE:
850
ADDRESS:2317 GOLD MEADOW WAYTELEPHONE:
(916) 730-8757
CITY:GOLD RIVERSTATE: CAZIP CODE:
95670
CAPACITY: 118TOTAL ENROLLED CHILDREN: 118CENSUS: 68DATE:
08/02/2024
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Nancy FugateTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Licensing Program Manager (LPM) Natalie Dunaway and Licensing Program Analyst (LPA) Erwina Pascual-Golamco met with Licensee Representative Nancy Fugate, for the purpose of an informal visit.

LPM defined the difference between non-compliance and an informal meeting. LPM advised that the purpose of today's meeting is to help the facility maintain compliance.

Today's informal meeting was to discuss the type A and type B citations issued on 7/2/24 (complaint).

On 7/2/24 the facility was cited a type A violation regarding supervision and a type B violation regarding reporting requirements.

The Director stated that they have taken the following steps to maintain compliance:

1. Staff were retrained on supervision and name to face.
2. Staff are repositioned in the playground for better supervision.
3. Staff check the yard and classrooms before transitions.

LPA discussed follow up documentation for file. LPA and LPM reviewed ratio, physical plant, and supervision requirements. LPM and LPA provided information regarding the Technical Support Program (TSP), which is a non-enforcement arm of the Community Care Licensing Division offering onsite support to licensees and providers. Director will follow up with request to LPA for TSP services. LPA discussed using the Department website (ccld.ca.gov) for child care updates, current forms, legislation and regulation information. LPM suggested that Licensee can view information videos at www.ccld.childcarevideos.org .

This report was reviewed with the Director.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2024
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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