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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393607982
Report Date: 02/17/2022
Date Signed: 02/17/2022 03:08:29 PM

Document Has Been Signed on 02/17/2022 03:08 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:TENDER LOVING CAREFACILITY NUMBER:
393607982
ADMINISTRATOR:RAMA, JENNIFERFACILITY TYPE:
840
ADDRESS:2324 PARKER AVE.TELEPHONE:
(209) 835-9088
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 0DATE:
02/17/2022
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:Cecilia Sanabria TIME COMPLETED:
03:15 PM
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On February 17, 2022 at 10:43 AM , Licensing Program Analyst (LPA) Stacey Williams met with Facility Representative for the purpose of an unannounced required annual inspection. Program hours are Monday through Friday 6:00AM-8:00AM and 2:00PM- 6:00PM. Upon arrival there were no children present at the facility. Criminal record clearances have been verified.

LPA conducted a health and safety inspection for all areas accessible to children. Staff stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. LPA observed a functional smoke/carbon monoxide detector and a fully charged 2A :10BC fire extinguisher. The floors appeared clean throughout the facility. Outdoor play area is free from dangerous conditions and playground equipment is securely anchored to the ground. Facility has gravel under the play equipment to absorb falls. Program provides afternoon snack. Menus were posted by the main entrance of the facility. Facility offers drinking water by utilizing a water fountain where each child’s individual cup is filled. Sign in/out sheet were reviewed.

One child file was reviewed. Child’s file contained an emergency card, and a medical assessment. Files for staff who were present at the facility were reviewed. Staff have a criminal record clearance, health screening report, immunization records, mandated reporter training, and documentation of their educational background, training, and/or experience. CPR certification was verified and expires on 9/2023.

LPA reviewed the Department's inspection authority and discussed with staff any changes that may occur regarding Director/Site Supervisor or an employee acting in the director's absence must be reported to department within 10 working days.

Report continues on 809-C

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2022
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: TENDER LOVING CARE
FACILITY NUMBER: 393607982
VISIT DATE: 02/17/2022
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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.

Per facility representative there are no children that require medication. Facility has an Incidental Medial Service Plan on file. Incidental Medical Services (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/process.

No Title 22 deficiencies were observed during today's inspection.

Exit interview conducted and report was reviewed with the Facility Representative, Cecilia Sanabria. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
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