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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243810089
Report Date: 03/04/2022
Date Signed: 03/04/2022 10:02:09 AM


Document Has Been Signed on 03/04/2022 10:02 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:SHATTUCK PARK HEAD STARTFACILITY NUMBER:
243810089
ADMINISTRATOR:JANET BENZIGERFACILITY TYPE:
850
ADDRESS:10082 VINCENT RDTELEPHONE:
(209) 381-5170
CITY:DELHISTATE: CAZIP CODE:
95315
CAPACITY:60CENSUS: 8DATE:
03/04/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Isabel Abundez - Education CoordinatorTIME COMPLETED:
10:15 AM
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On 3/4/22, Licensing Program Analyst (LPA) Joseph Pacheco conducted an unannounced case management inspection. LPA met with Education Coordinator, Isabel Abundez toured the facility inside and outside and a census was taken. The purpose of today's inspection was to inspect new play equipment that was installed in the outdoor play area for use for the preschool children. LPA observed one slide and five play stations at ground level. The five play stations also include a shade structure. Children access the slide by walking up a rubber cushioned ramp in lieu of climbing a ladder. Sand and rubber cushioning are being used. Adequate cushioning around the slide and play stations was observed to absorb falls. The play stations do not contain any high climbing equipment. Manufacturer specifications state the new play equipment is suitable for children ages 2-5 years old. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Playground equipment is in good condition, free of sharp, loose, or pointed parts. LPA reminded Education Coordinator to ensure that manufacturer’s instructions are followed at all times when using the equipment and reminded Education Manager to discuss with staff best practices for maintaining visual supervision at all times when children are playing outdoors.

Effective today, 3/4/22, the facility may begin using the new outside play equipment for preschool children.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted and report was reviewed with Education Coordinator, Isabel Abundez.

This report shall be made available to the public upon request. 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.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:
DATE: 03/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/04/2022
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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