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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570305772
Report Date: 01/08/2025
Date Signed: 01/08/2025 12:48:50 PM

Document Has Been Signed on 01/08/2025 12:48 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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ST. PAUL'S LUTHERAN PRESCHOOLFACILITY NUMBER:
570305772
ADMINISTRATOR/
DIRECTOR:		UPTON, CORRIEFACILITY TYPE:
850
ADDRESS:625 WEST GIBSON ROADTELEPHONE:
(530) 662-1935
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 46TOTAL ENROLLED CHILDREN: 46CENSUS: 15DATE:
01/08/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:director, Corrie UptonTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Lauren Scott met with director, Corrie Upton for the purpose of a case management inspection regarding the outdoor play area. The program operates Monday through Friday from 7:00 a.m. to 5:45 p.m.

LPA Scott arrived at the facility to inspect the new play structure. At time of inspection, LPA toured the entire facility. LPA observed a new play structure that is suitable for ages 2-12. LPA observed sufficient cushioning (wood chips) under the play structure. No changes were made to the outdoor play area's square footage.

LR was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.



A notice of site visit was posted and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the director, Corrie Upton.

Effective today, 1/8/2025, LPA will approve the facility to continue usage of original outdoor play space with new structure as well.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2025
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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