393605862-7-8-2020-53-CC-SWIS-BRBM92-20200708092403

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393605862
Report Date: 07/07/2020
Date Signed: 07/08/2020 09:24:10 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 STATE PRESCHOOL		FACILITY NUMBER:	393605862
ADMINISTRATOR:	RHOADES, MARTI		FACILITY TYPE:	850
ADDRESS:	1750 KAVANAGH STREET		TELEPHONE:	(209) 832-8799
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	48	CENSUS: 5	DATE:	07/07/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	03:54 PM
MET WITH:	Maria Rodriguez		TIME COMPLETED:	04:40 PM

NARRATIVE

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Due to the COVID-19 pandemic, Licensing Program Analyst (LPA) Stacey Williams conducted a Case management Tele-Visit via Google Duo Video Conferencing with staff Maria Rodriguez on July 7, 2020 in lieu of conducting an onsite inspection. Ms. Rodriguez guided LPA on a Tele-Visit tour throughout the preschool and school age facility. Today’s census for the preschool program included five children supervised by three teachers. LPA observed all teachers wearing masks in both programs, however children in the preschool program were not seen with masks. A varied amount of school age children was seen with masks.

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 met via conference call with Program Director Jodi Delsino, Site Supervisor, Christy Ziller, and Center Compliance Manager, Fritzi Gragg to discuss the purpose of today’s inspection. LPA advised staff to continue to stay abreast to local county and state ordinances concerning COVID-19 best practices 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 Site Supervisor, Christy Ziller. 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: 07/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2020

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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