390317608-7-16-2019-53-CC-CJAN-BE5U4T-20190716151540

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 390317608
Report Date: 07/16/2019
Date Signed: 07/16/2019 03:15:49 PM

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:	GRUNSKY ELEMENTARY SCHOOL		FACILITY NUMBER:	390317608
ADMINISTRATOR:	JAJAR, CHARLES		FACILITY TYPE:	850
ADDRESS:	1550 N. SCHOOL		TELEPHONE:	(209) 953-4750
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95205
CAPACITY:	24	CENSUS: 0	DATE:	07/16/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Debra Keller		TIME COMPLETED:	03:25 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's) Charlotte Baney and Chris Jackson met with the District Director Debra Keller today for a pre-licensing/case management inspection. The applicant is requesting a license to serve 44 preschool age children in 2 new portable buildings. The facility plans to operate Monday - Friday from 8:00AM - 3:30 on the Grunsky Elementary School site. Portable P8 is for State Pre School which will operate 8:00-11:30 and 12:00-3:30. The program will serve breakfast and lunch. There is 2 toilets and 3 sinks in that portable and the capacity in that portable will be 22 pre school children. Portable P9 is a Head Start program there is 3 toilets and 3 sinks, they will serve breakfast and lunch. The hours are 8:00-3:30 the age will be 3 into kindergarten. The facility has a copy of the following documents posted in a conspicuous area: parent's rights, personal rights, emergency disaster plan, earthquake preparedness checklist and car seat law. INDOOR ACTIVITY SPACE: The classroom is equipped with child size furnishings and age appropriate toys and equipment. There are individual cubbies for storing the children's personal belongings. The facility will be providing AM/PM snack, breakfast and lunch depending on the program and all food will be prepared by the elementary school kitchen. A drinking fountain in both classrooms was observed which will be utilized by the children. LPA observed a complete first aid kit in the classrooms. Report Continues on 809-C

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019

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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: GRUNSKY ELEMENTARY SCHOOL	FACILITY NUMBER: 390317608
	VISIT DATE: 07/16/2019

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
26
27
28
29
30
31
32

There are sufficient fixtures to support the requested capacity of 22 children in each portable. There is a separate bathroom to be used by staff and ill children. The isolation area for sick children will be in the directors office. Medications will be stored in the directors office and are inaccessible or out of children reach. LPA discussed the new requirements for providing Incidental Medical Services - IMS. All cleaning supplies are stored appropriately.

Total Indoor Activity Space for room # P9 = 1139 square feet, divided by 35 square feet, provides sufficient indoor activity space for up to 32 children and this will support the total requested capacity of 22 children for this license.

Total Indoor Activity Space for room # P8= 782 square feet, divided by 35 square feet, provides sufficient indoor activity space for up to 22 children and this will support the total requested capacity of 22 children for this license.

OUTDOOR ACTIVITY SPACE:

The outdoor play area is fenced and is equipped with age-appropriate equipment as follows: large play structure, and cemented area for bikes and other activities.

There will be canopy's for shade . There is ample cushioning materials under climbing structures.

Total Outdoor Activity Space = 4887.995 square feet, divided by 75 square feet, provides sufficient outdoor activity space for 65 children and will support the requested capacity of 44 children.

A fire clearance was granted for 44 children on 6/26/19. LPA will grant a standard license to serve 44 preschoolers from age three to entry into Kindergarten.

Exit interview was conducted.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2