393604765-10-20-2020-53-CC-SWIS-BUKN7X-20201020101328

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393604765
Report Date: 08/12/2020
Date Signed: 10/20/2020 10:13:30 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:	MELVILLE S. JACOBSON CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	393604765
ADMINISTRATOR:	RHOADES, MARTI		FACILITY TYPE:	840
ADDRESS:	1750 KAVANAGH STREET		TELEPHONE:	(209) 832-8799
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	70	CENSUS: 10	DATE:	08/12/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Jodi Delfino		TIME COMPLETED:	01:00 PM

NARRATIVE

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Due to the COVID-19 pandemic, Licensing Program Analyst (LPA) Stacey Williams conducted a Case Management Tele-Visit with Sr. Program Director, Jodi Delfino on August 12, 2020 in lieu of conducting an onsite inspection. Today’s census for the facility is 10 children supervised by two staff.

The purpose of today’s inspection was to discuss best practices and the COVID-19 Updated Guidance concerning social distancing and wearing masks for adults and children per the Governors order. LPA discussed the measures currently being taken by the facility concerning face masks and social distancing. LPA advised staff to continue to stay abreast to local county and state ordinances concerning COVID-19 best practices in a childcare setting. Sr. Program Director informed LPA that all staff will be reminded of the guidelines concerning face coverings in a childcare setting.

In the areas that were evaluated there were no deficiencies observed.

Exit interview conducted and appeal rights were discussed. A copy of this report, Notice of Site Visit, and appeal rights were emailed to the Sr. Program Director Jodi Delfino. Hard copy of the report with signature will be on file.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2020

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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