390305456-5-18-2022-53-CC-CJAN-CEJTCF-20220518143639

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 390305456
Report Date: 05/18/2022
Date Signed: 05/18/2022 02:36:47 PM

Document Has Been Signed on 05/18/2022 02:36 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	ST. PAUL'S UNITED METHODIST PRESCHOOL		FACILITY NUMBER:	390305456
ADMINISTRATOR:	BERRY, BELINDA		FACILITY TYPE:	850
ADDRESS:	910 EAST NORTH STREET		TELEPHONE:	(209) 239-5848
CITY:	MANTECA	STATE: CA	ZIP CODE:	95336
CAPACITY:	68	CENSUS: 0	DATE:	05/18/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Belinda Berry		TIME COMPLETED:	02:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Christopher Jackson met with Director, Belinda Berry for the purpose of an unannounced Annual inspection. Upon arrival LPA learned the facility had ended there session. The director allowed for LPA to continue the inspection process with zero children in care. LPA toured the facility inside and out. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility operates one part day sessions. The session operates Monday - Friday from 9:00 am to 12:00 pm. LPA reviewed staffing ratios, first aid supplies, furniture, equipment, fire drills and drinking water. LPA observed all required forms to be posted. LPA observed functioning carbon monoxide and smoke alarms. LPA observed fire extinguishers that meet regulation in each classroom. The facility consists of three separate classrooms. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure appeared to be in good repair, and there is sufficient cushioning under the play structure. LPA reviewed the sign in/out sheets and observed that the children are properly signed in/out. LPA reviewed ten children’s files during today's inspection. LPA reviewed two staff files during today's inspection. All staff present during today's inspection have a fingerprint clearance. Facility representative 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. Report continues on 809-C.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: ST. PAUL'S UNITED METHODIST PRESCHOOL	FACILITY NUMBER: 390305456
	VISIT DATE: 05/18/2022

NARRATIVE

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LPA observed health screening reports with TB test and required MMR and TDAP vaccines in staff files reviewed. At least one staff member present today has current Pediatric CPR and First Aid which expires on 04/23/24.. LPA observed AB1207 Mandated Reporter training certificates for all staff. The Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

LPA checked that annual fees are current.

This provider is not currently providing Incidental Medical Services (IMS) services to children in care. IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with the Facility representative. A notice of site visit was posted and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, no deficiencies were cited during the inspection.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022

LIC809 (FAS) - (06/04)

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