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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
343624323
Report Date:
11/06/2024
Date Signed:
11/06/2024 10:55:18 AM
Document Has Been Signed on
11/06/2024 10:55 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:
ADVENTURE MONTESSORI S.T.E.A.M ACADEMY LLC
FACILITY NUMBER:
343624323
ADMINISTRATOR/
DIRECTOR:
SITHUMINI MILLAWABANDARA
FACILITY TYPE:
830
ADDRESS:
3541 N FREEWAY BLVD SUITE 100
TELEPHONE:
(916) 370-6113
CITY:
SACRAMENTO
STATE:
CA
ZIP CODE:
95834
CAPACITY:
8
TOTAL ENROLLED CHILDREN:
8
CENSUS:
4
DATE:
11/06/2024
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:
Sithumini Millawabandara
TIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On 11/6/24 Licensing Program Analysts (LPAs) Mandie Goodwin and Amanda Sutter met with Director Sithumini Millawabandara for the purpose of a case management to deliver an amended report. Upon arrival LPAs observed 4 infants supervised by 1 staff member.
LPAs did not observe any deficiencies during todays visit. Exit interview was conducted and report was reviewed with Director. A notice of site visit was provided.
SUPERVISORS NAME
:
Seychelle De Luca
LICENSING EVALUATOR NAME
:
Mandie Goodwin
LICENSING EVALUATOR SIGNATURE
:
DATE:
11/06/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/06/2024
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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