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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390319214
Report Date: 10/15/2019
Date Signed: 10/15/2019 11:09:37 AM

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:PARKLANE STATE PRESCHOOLFACILITY NUMBER:
390319214
ADMINISTRATOR:D. RODRIGUEZ/L. HANEYFACILITY TYPE:
850
ADDRESS:8405 TAM O'SHANTERTELEPHONE:
(209) 953-8415
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:72CENSUS: 38DATE:
10/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Mai XiongTIME COMPLETED:
11:30 AM
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On 10/15/2019 at 09:15am Licensing Program Analysts (LPAs) Aruna Sridharan and Amanda Blesi conducted an unannounced Annual Required Inspection and met with Site Supervisor Mai Xiong. This facility has three portables in the Parklane Elementary School Campus.. 38 children and 6 staff and one parent were present in the facility during this inspection. Facility is within ratio during this inspection. The facility consists of 3 classrooms with bathroom in each classroom and an outdoor play area. The classroom has heating and ventilation for safety and comfort. This facility operates under Title 5 program. The hours of operation for AM program 7:30am to 11:00, PM program from 12:00 to 3:30pm and Duration program from 8:00 to 2:00pm . The breakfast, snacks and lunch is provided by the Lodi School District

At approximately time 10:00am the three sign in-out sheets was reviewed. LPAs conducted an indoor and outdoor tour of the facility. The three classrooms observed clean and orderly with ample age appropriate toys. Site Supervisor stated that toys are sanitized by staff on a rotational basis. LPAs observed cubbies for each child labeled and orderly. Classroom 32 is used for napping. All three classroom floors were clean and safe, the children's furniture was clean and age appropriate. Drinking water is immediately accessible to children both indoors and outdoors. Bathrooms are working and clean.

A weekly menu was posted on the parent board with all other required postings.LPAs observed working carbon monoxide and complete first aid kit. Cleaning supplies and medication cabinets were high up and inaccessible to children. LPAs observed the outdoor play area, the play structure was securely anchored, cushioned material with woodchips underneath to absorb a fall and ample shade as well.

No Title 22 deficiencies were cited during today's inspection. LPAs read this report and an exit interview was conducted with the Site Supervisor. A copy of this report and appeal rights were discussed and left with Site Supervisor whose signature on this form confirm receipt of these documents.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
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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