<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390319952
Report Date: 05/23/2019
Date Signed: 05/23/2019 12:34:51 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:TAFT SCHOOLFACILITY NUMBER:
390319952
ADMINISTRATOR:ULMER, SYLVIAFACILITY TYPE:
850
ADDRESS:419 DOWNING AVENUETELEPHONE:
(209) 953-2011
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY:102CENSUS: 17DATE:
05/23/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Ms. HendersonTIME COMPLETED:
01:30 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) Charlotte Baney met with Teacher, Ms. Henderson for a case management inspection on this date to discuss the unusual incident report (UIR) that the program submitted and which occurred on April 25, 2019. During today's inspection the facility was toured. There were seventeen children present today being supervised by four staff.

LPA did not observe any deficiencies during today's visit.



Notice of Site Visit was provided today.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Charlotte BaneyTELEPHONE: (916) 216-7791
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2019
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 1