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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 553616866
Report Date: 12/06/2023
Date Signed: 12/06/2023 11:32:06 AM

Document Has Been Signed on 12/06/2023 11:32 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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ATCAA - BLUE BELL HEAD STARTFACILITY NUMBER:
553616866
ADMINISTRATOR:BREENA SMITHFACILITY TYPE:
850
ADDRESS:18080 BLUE BELL ROAD EASTTELEPHONE:
(209) 533-1397
CITY:SONORASTATE: CAZIP CODE:
95370
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 20DATE:
12/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Operations Manager, Jackie RobertsTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Lauren Scott and Centralized Application Bureau (CAB) Alecia Sifuentes (AS) met with Operations Manager, Jackie Roberts for the purpose of a room addition case management inspection. Licensee is not requesting any changes to the capacity. Licensee requests to add additional classrooms to the toddler option program, which were previously the infant room that is now closed. The program operates Monday through Friday from 8:00a.m. to 2:30p.m.

INDOOR ACTIVITY SPACE:
There is one preschool room and two toddler rooms. LPA and CAB observed a sufficient amount of equipment, toys, tables, chairs, nap mats, and cubbies. There are 3 toilets and 8 sinks. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). CAB measured the toddler classrooms which was added to the current preschool square footage. The total indoor square footage for the preschool and toddler classrooms, contains a total of 1,913 square feet, which will accommodate facility's current capacity of 22 preschool children and 8 toddlers.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Operations Manager, Jackie Roberts.

Effective today, 12/6/2023, LPA will approve the room addition.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2023
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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