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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390319172
Report Date: 02/18/2022
Date Signed: 02/18/2022 01:38:23 PM

Document Has Been Signed on 02/18/2022 01:38 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:WESTWOOD STATE PRESCHOOLFACILITY NUMBER:
390319172
ADMINISTRATOR:LOPEZ, MARY LISAFACILITY TYPE:
850
ADDRESS:9444 CAYWOODTELEPHONE:
(209) 953-8001
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 41TOTAL ENROLLED CHILDREN: 41CENSUS: 24DATE:
02/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Lindsay StephensTIME COMPLETED:
02:00 PM
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On 2/18/22 Licensing Program Analysts (LPA) Aruna Sridharan met with Lindsay and Carmen for the purpose of annual inspection. Today census was 16 children and three staff in Headstart and 8 children and three staff in State Preschool. LPA toured the building including classrooms P1 and P2, restrooms and outdoor play area. LPA observed appropriate ratios, care and supervision, and capacity during the visit. The hours of operation are Monday through Friday. The State Preschool hours are AM session from 8:00am to 11:00am and afternoon session from 12:00pm to 3:00pm and Headstart is from 8:00am to 2:00pm. The school year began on August 3, 2021 and last day is June 2, 2022.

Medications, disinfectants, cleaning solutions, and hazardous items were appropriately stored and inaccessible to children. First Aid was centrally located but inaccessible to children. Furniture, equipment, and play materials were in good condition. Playground equipment was free of loose and sharp parts. The areas under and around playground climbing equipment were cushioned with wood chips to absorb falls. There are 4 toilets and 4 sinks. Toileting facilities were in operating, safe, and sanitary condition. Uncontaminated drinking water is readily available to children both indoors and outdoors. Licensing representative Lindsay stated that the facility provided breakfast and lunch through the school in the cafeteria. LPA observed a current menu posted. LPA observed Sign In/Out Sheet with signatures, times, and dates. The facility conducts fire drills along with the school district per record the last drill was conducted 12/21. The children's roster was current and updated for both classrooms.
LPA reviewed 15 children’s files and observed that each child had their Identification/Emergency Information and the Consent for Medical Treatment form filled out and signed by their authorized representative.

Report continues on 809C page......
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Aruna Sridharan
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2022
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: WESTWOOD STATE PRESCHOOL
FACILITY NUMBER: 390319172
VISIT DATE: 02/18/2022
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At least one staff member present today had current Pediatric CPR and First Aid certification (expires 10//23). All staff currently employed with the facility have proof of immunizations. LPA also reviewed documentation of qualifications including education and experience. All staff members have mandated reporter training AB 1207 completed from a third party approved vendor. Certificates are on file.
LPA also discussed Unusual Incident Reports (UIRs) and reporting requirements. LPA informed the Director that if any unusual incidents occur she must contact the Department within 24 hours and an UIR must be submitted with 7 day, describing the specifics to the incident.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the licensee of their responsibility to stay current in regards to new regulations.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report and provided copies to the facility. A notice of site visit was given and must remain posted for30 days. Exit interview conducted and report was reviewed with the facility representative (include name).

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Aruna Sridharan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2022
LIC809 (FAS) - (06/04)
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