393612088-1-27-2022-53-CC-ASIS-CB3PLR-20220127102509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393612088
Report Date: 01/27/2022
Date Signed: 01/27/2022 10:25:16 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:	TENDER LOVING CARE		FACILITY NUMBER:	393612088
ADMINISTRATOR:	BANDY, CHARLA		FACILITY TYPE:	840
ADDRESS:	1219 WHISPERING WIND DRIVE		TELEPHONE:	(209) 832-2990
CITY:	TRACY	STATE: CA	ZIP CODE:	95377
CAPACITY:	35	CENSUS: 0	DATE:	01/27/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Stephanie Dunn		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	Application Specialist (AS) Alecia Sifuentes met with Licensee, Stephanie Dunn for the purpose of an announced case management inspection. Licensee requests a change of capacity and room addition. The facility's hours of operation are Monday through Friday from 6:00 a.m. to 6:00 p.m. AS received the elementary schools annual fire inspection on 11/17/2021. A health and safety inspection was conducted in all areas accessible to children. Licensee is requesting a capacity increase of 70 school-age children. Superintendent/Principal letter is on file allowing the program to utilize portables 7 and 8. Licensee stated that portable 7 will be utilized by the preschool program from 8:00 a.m. to 12:00 p.m. and the school-age children from 1:00 p.m. to 6:00 p.m. Per Health and Safety Code 1596.806, the facility is exempt from square footage requirement; therefore, AS did not take measurements. The children will use the school’s restrooms, and a separate private restroom for the staff. 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. Licensee 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 LIC809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: 393612088
	VISIT DATE: 01/27/2022

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
26
27
28
29
30
31
32

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-
care-licensing/subscribe and select the Child Care option to receive email communication.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Stephanie Dunn.

Effective today, 1/27/2022, AS will approve the facility’s classroom addition and capacity change for 70 school-age children.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2