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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393604413
Report Date: 09/10/2019
Date Signed: 09/10/2019 11:45:33 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:WEBER TECHNICAL INSTITUTE PRESCHOOLFACILITY NUMBER:
393604413
ADMINISTRATOR:MOMBERG, KNUTEFACILITY TYPE:
850
ADDRESS:302 W.WEBER, CLASSROOM ATELEPHONE:
(209) 467-7054
CITY:STOCKTONSTATE: CAZIP CODE:
95203
CAPACITY:44CENSUS: 31DATE:
09/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Phalla SanTIME COMPLETED:
11:55 AM
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Licensing Program Analyst (LPA) Charlotte Baney met with the Teacher Phalla San for an annual/random inspection. LPA toured the facility, including all activity/classroom areas, the isolation area, rest-room and outdoor play areas. LPA reviewed care and supervision of children, staffing ratios, first aid supplies, furniture, equipment, fire drills, drinking water and food service provisions.
LPA observed all required forms to be posted. During today's visit LPA did not observe any medication in the facility. First aid supplies were available. There are adequate toys and equipment available for children. The rest-room were observed to be in working order. Center menus are posted at the center. Center has an updated fire drill log. At least one staff member present today has current Pediatric CPR and First Aid.
LPA reviewed the sign/in-sign/out sheet. LPA reviewed children's emergency card. All currently employed with the Center have criminal record clearances and health screening. This facility is not providing Incidental Medical Services-IMS at this time.
LPA advised the teacher of the Notice of Site Visit posting requirement. LPA provided the Licensing Agency website (www.ccld.ca.gov), so the lead teacher and/or staff may obtain updated licensing information, regulations, and forms.
In the areas that were evaluated, no deficiencies were observed at the time of the inspection. Exit interview was conducted.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Charlotte BaneyTELEPHONE: (916) 216-7791
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019
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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