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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393611183
Report Date: 03/07/2023
Date Signed: 03/07/2023 09:38:51 AM

Document Has Been Signed on 03/07/2023 09:38 AM - 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:BECKMAN STATE PRESCHOOLFACILITY NUMBER:
393611183
ADMINISTRATOR:LOPEZ, MARY LISAFACILITY TYPE:
850
ADDRESS:2201 SCARBOROUGH DRIVETELEPHONE:
(209) 331-7252
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: DATE:
03/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Sandi WaitesTIME COMPLETED:
09:50 AM
NARRATIVE
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Licensing Program Analyst (LPA) Erwin Tjhia met with Teacher Sandi Waites to deliver an amended version of a report created on 2/23/2023.

There were 9 children and 2 teachers present at today's inspection.

No deficiencies were observed. An exit interview was conducted.

A Notice of Site Visit was posted and must remain posted for 30 days.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2023
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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