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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500623
Report Date: 08/11/2023
Date Signed: 08/11/2023 10:22:06 AM

Document Has Been Signed on 08/11/2023 10:22 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:WOODLAND HAVEN PRESCHOOLFACILITY NUMBER:
574500623
ADMINISTRATOR:ASHLEY TOBURENFACILITY TYPE:
830
ADDRESS:1738 COTTONWOOD STREETTELEPHONE:
(530) 312-6690
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: DATE:
08/11/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ashley ToburenTIME COMPLETED:
11:00 AM
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Application Specialist (AS) Alecia Sifuentes and Licensing Program Analyst (LPA) Lauren Scott met with Director, Ashley Toburen for the purpose of a case management inspection. Licensee requests a change of capacity to serve 24 children from age 0-24 months and 28 toddlers age 18-36 months under the Toddler Option Program. The program operates Monday through Friday from 7:00 a.m. to 6:00 p.m. The fire clearance was received and granted on 8/8/2023.

INDOOR ACTIVITY SPACE:
There is one infant classroom and one toddler classroom. AS observed a sufficient amount of equipment, toys, tables, chairs, highchairs, cubbies, napping cots, and 8 cribs. Director stated that they currently only utilize six cribs due to most of the infants being over the age of twelve months. Director acknowledges there will be a maximum of 8 infants under 12 months old, due to available cribs. AS used current measurements from report dated 9/6/2022 therefore AS did not take measurements. The total classroom space contains a total of 1,823 square feet, which will accommodate Licensee's request for 24 infants and 28 toddlers. There are 2 toilets, potty chairs, and 6 sinks for the children, and a separate private restroom for the staff. AS observed two sinks within arm’s reach of two changing table located in the infant classroom.

OUTDOOR ACTIVITY SPACE:
There is one infant and toddler outdoor area on the property. AS observed a Shared Outdoor Space Waiver posted and on file. AS used current measurements from report dates 9/6/2022 therefore AS did not take measurements. The outdoor play area contains a total of 3,018 square feet, which will accommodate Licensee's request for 24 infants and 28 toddlers.

Report continues on LIC809-C.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: WOODLAND HAVEN PRESCHOOL
FACILITY NUMBER: 574500623
VISIT DATE: 08/11/2023
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Director 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.

Director 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 given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Ashley Toburen.

Effective today, 8/11/2023, AS will approve the change of capacity to service 24 children from age 0-24 months (with a maximum census of 8 infants under 12 months old due to available cribs) and 28 toddlers age 18-36 months under the Toddler Option Program.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
LIC809 (FAS) - (06/04)
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