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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393605949
Report Date: 08/01/2024
Date Signed: 08/01/2024 02:28:26 PM


Document Has Been Signed on 08/01/2024 02:28 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:TRACY UNIFIED SCHOOL DISTRICT SOUTH/WEST PARK ELEMFACILITY NUMBER:
393605949
ADMINISTRATOR:GARCIA, ROCIOFACILITY TYPE:
850
ADDRESS:500 WEST MOUNT DIABLO AVETELEPHONE:
(209) 830-3355
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY:32CENSUS: 0DATE:
08/01/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:53 PM
MET WITH:Tasha MathewsTIME COMPLETED:
02:50 PM
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On August 1, 2024, Licensing Program Analysts (LPAs) Stacey Williams and Elvira Sierra met with Facility Representative, Tasha Mathews for the purpose of a case management inspection. Licensee requests a classroom addition to add room D101. Licensee is not making any changes to the capacity at this time. The facility's hours of operation are Monday through Friday from 8:30 a.m. to 11:30 a.m. and 12:30 p.m. to 3:30 p.m. The granted fire clearance was received on 7/26/2024 by Tracy FD-South County Fire Authority Community Risk Reduction. There were no children present during today's inspection.

A health and safety inspection was conducted in all areas accessible to children. The facility is currently operating in classroom E101 and is requesting an additional preschool classroom be added to the license. LPAs measured classroom D101 as the added preschool classroom. The total classroom space for classroom D101 contains a total of 1,092.9 square feet, which will accommodate a capacity of 31 preschool children. There are two toilets and two sinks available to children, and a separate staff restroom is available outside of the classroom. A Shared Bathroom and Playground Waiver is on file. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). LPAs observed disinfectants are inaccessible and appropriately stored.

This facility provides Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

This facility evaluation report was reviewed and discussed with the Facility Representative. Facility Representative was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining to childcare centers.

Facility Representative and LPAs discussed an increase of capacity for the license during today's inspection. Facility Representative will discuss the increase of capacity option with the School Readiness Coordinator and follow up with Community Care Licensing Regional Office should they decide to go forward with the increase application.

Updated facility license will be mailed by the Regional office which will include the added preschool classroom.

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.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2024
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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