393611183-1-24-2020-53-CC-ASIS-BL5QKB-20200124111405

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393611183
Report Date: 01/24/2020
Date Signed: 01/24/2020 11:14:15 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:	BECKMAN STATE PRESCHOOL		FACILITY NUMBER:	393611183
ADMINISTRATOR:	LOPEZ, MARY LISA		FACILITY TYPE:	850
ADDRESS:	2201 SCARBOROUGH DRIVE		TELEPHONE:	(209) 331-7255
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	24	CENSUS: 16	DATE:	01/24/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sandi Waites		TIME COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Alecia Sifuentes met with Sandi Waites, Morning Site Supervisor, for an unannounced annual/random inspection. Sixteen preschool-age children and two staff members and one ROP student were present. The program conducts part-time sessions in Portable 1 (PS1) on the campus of Beckman Elementary School, 7:30 a.m. to 11:00 a.m. and 11:55 p.m. to 3:05 p.m. A tour of facility was conducted inside and outside. PS1 has a bathroom with two toilets and one sink, and a second sink is available to children in the classroom. A waiver for shared playground is on file and posted. There was sufficient staff to meet ratio requirements. Drinking water is available both inside and outside. Cleaning solutions and other items that are dangerous to children are kept in a safe place inaccessible to children. Five children’s files were reviewed. Emergency Contact Information is located in the Emergency Facility Binder. Adequate supervision was provided during today’s visit. The program provides breakfast and lunch. Sign in/sign out sheets and roster are maintained. The facility conducts fire drills with the elementary school every month. LPA confirmed annual fees to be current. One staff file was reviewed showing current CPR/First Aid Certificate expiring on 7/17/2020. All staff have criminal record clearance through the Lodi Unified School District. LPA reviewed health screening report, TB, immunization's, documentation of the educational background and experience, and AB 1207 Mandated Reporter Training certification expiring on 8/3/2020. Report continues on 809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

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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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: BECKMAN STATE PRESCHOOL	FACILITY NUMBER: 393611183
	VISIT DATE: 01/24/2020

NARRATIVE

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This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the Site Supervisor and provided copies. An exist interview was conducted. LPA observed the Notice of Site Visit posted and the Site Supervisor understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

LIC809 (FAS) - (06/04)

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