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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390321278
Report Date: 10/11/2019
Date Signed: 10/11/2019 09:44:11 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:SAN JOAQUIN DELTA COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
390321278
ADMINISTRATOR:COOK, NANCYFACILITY TYPE:
850
ADDRESS:5151 PACIFIC AVETELEPHONE:
(209) 954-5702
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:144CENSUS: 49DATE:
10/11/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Nancy CookTIME COMPLETED:
09:50 AM
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Licensing Program Analyst (LPA) Christopher Jackson and Office Technician Ryan Martin conducted an unannounced case management inspection at the San Joaquin Delta Child Development Center. The purpose of the inspection is to verify that the required removal of the individual not cleared to work at the facility. LPA has confirmed Dalton Aro has been removed and is not working at the facility. LPA Jackson verified that all staff present today has a criminal record clearance. LPA Jackson toured/inspected the facility inside and out.

Based on evidence obtained during today's inspection, the LPA has verified that the individual is not present, employed, or residing at the facility. LPA has advised the licensee to disassociate the individual from their roster and submit an updated LIC 500.

As a result of today’s inspection, No Title 22 deficiency cited. Report was reviewed with the director. Notice of site visit provided and should remain posted for 30 days.

Verification of removal is complete.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
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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