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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570300647
Report Date: 05/06/2024
Date Signed: 05/06/2024 09:41:48 AM

Document Has Been Signed on 05/06/2024 09:41 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:ST. LUKE'S PRESCHOOLFACILITY NUMBER:
570300647
ADMINISTRATOR/
DIRECTOR:		LAURIE MOOREFACILITY TYPE:
850
ADDRESS:515 SECOND STREETTELEPHONE:
(530) 662-1853
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 19DATE:
05/06/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:director, Laurie MooreTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Lauren Scott met with Director, Laurie Moore for the purpose of an unannounced plan of correction inspection to clear a Type A deficiency, which was issued on 04/29/24 regarding ratios.

During today's inspection LPA toured all areas accessible to children in care and observed ratios to be maintained.

Deficiencies cited on 04/29/2024 are cleared effective today. Exit interview conducted and report was reviewed with the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2024
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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