393600065-1-11-2023-53-CC-MMEK-CMYTX8-20230111140642

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393600065
Report Date: 01/11/2023
Date Signed: 01/11/2023 02:06:57 PM

Document Has Been Signed on 01/11/2023 02:06 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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	KENNEDY SCHOOL		FACILITY NUMBER:	393600065
ADMINISTRATOR:	BERMUDEZ, ANTOINETTE		FACILITY TYPE:	850
ADDRESS:	630 PONCE DE LEON		TELEPHONE:	(209) 953-3150
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95210
CAPACITY:	43	CENSUS: 8	DATE:	01/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Sandra Plado		TIME COMPLETED:	02:15 PM

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Licensing Program Analysts (LPA’s) Mariya Melnichuk and Lauren Scott met with Teacher Sandra Plado for the purpose of an unannounced Annual inspection. LPA’s toured the facility inside and out. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility days and hours of operation are Monday-Friday from 8:00 AM to 11:00 AM and 12:00 PM to 3:00 PM. There were eight children present during today's inspection, one teacher and one assistant teacher. Facility runs on a 10 month program from August-June.

LPA reviewed staffing ratios, first aid supplies, furniture, equipment, fire drills and drinking water. LPA observed all required forms to be posted. LPA observed functioning carbon monoxide and smoke alarms. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure appeared to be in good repair, and there is sufficient cushioning (square cushioned turf tiles) under the play structure. All food is provided by the school district. The AM class is provided with breakfast and the PM class is provided with lunch.

LPA reviewed the sign in/out book and observed that the children are properly signed in/out. LPA reviewed children’s and staff files. All staff present during today's inspection have a fingerprint clearance through the school district. Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Report continues on 809-C.

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Mariya Melnichuk	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: KENNEDY SCHOOL	FACILITY NUMBER: 393600065
	VISIT DATE: 01/11/2023

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Children and staff files were reviewed. Each child's file contained an emergency card and other required documents. LPA observed required documents, including health screening reports with TB test and required MMR and TDAP vaccines, for staff. At least one staff member present today has current Pediatric CPR and First Aid (exp. 09/2024). LPA observed AB1207 Mandated Reporter training certificates for staff. The Facility representative was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

LPA checked that annual fees are current.

This facility is not currently providing Incidental Medical Services (IMS) services to children in care. IMS policy was discussed.
For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.

Exit interview conducted and report was reviewed with the Facility representative. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, no deficiencies were cited during the inspection.

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Mariya Melnichuk	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC809 (FAS) - (06/04)

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