393611183-2-23-2023-53-CC-ETJA-CPBPLC-20230223102431

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393611183
Report Date: 02/23/2023
Date Signed: 02/23/2023 10:24:41 AM

Document Has Been Signed on 02/23/2023 10:24 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 PRESCHOOL		FACILITY NUMBER:	393611183
ADMINISTRATOR:	LOPEZ, MARY LISA		FACILITY TYPE:	850
ADDRESS:	2201 SCARBOROUGH DRIVE		TELEPHONE:	(209) 331-7252
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	24	CENSUS:	DATE:	02/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sandi Waites, Esmeralda Sandoval		TIME COMPLETED:	11:00 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 Analysts (LPA) Erwin Tjhia and Licensing Program Manager (LPM) Bettina Engelman, met with Teachers, Sandi Waites and Emesralda Sandoval for the purpose of an unannounced Annual inspection. LPA and LPM toured the facility inside and out. Facility days and hours of operation are Monday-Friday from 7:30 AM to 11 AM . Facility provides breakfast and lunch which is supplied by the school district. There were 13 children present during today's inspection. LPA reviewed staffing ratios, first aid supplies, furniture, equipment, fire drills and drinking water. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. LPA observed all required forms to be posted. LPA observed functioning carbon monoxide and smoke alarms. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure appeared to be in good repair, and there is sufficient cushioning (artificial grass) under the play structure. LPA reviewed the sign in/out book and observed that the children are properly signed in/out. LPA reviewed children’s and staff files. All staff present during today's inspection have a fingerprint clearance through the Lodi School District. 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. Report continues on 809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Erwin Tjhia	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

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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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: 02/23/2023

NARRATIVE

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******This is an amended version of the report 809-C created on 02/23/2023. **********

The teacher stated that the facility does not provides Incidental Medical Services (IMS) at this moment. LPA reviewed storage of medications and equipment/supplies, and reviewed children’s personnel, and administrative records. 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/inspection-process.

Exit interview conducted and report was reviewed with the Facility representative. 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.

In the areas that were evaluated, no deficiencies were cited during the inspection.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Erwin Tjhia	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

LIC809 (FAS) - (06/04)

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