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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393613012
Report Date: 09/01/2022
Date Signed: 09/01/2022 12:05:19 PM


Document Has Been Signed on 09/01/2022 12:05 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:PRESCHOOL FOR ALL @ GREAT VALLEYFACILITY NUMBER:
393613012
ADMINISTRATOR:ESTHER JACKSON (ROOM 51)FACILITY TYPE:
850
ADDRESS:4223 MC DOUGALD BLVD.TELEPHONE:
(209) 938-6300
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY:48CENSUS: 0DATE:
09/01/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Esther JacksonTIME COMPLETED:
12:30 PM
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Application Specialist (AS) Alecia Sifuentes met with Director, Esther Jackson for the purpose of an announced case management inspection. Licensee requests a change of capacity to lower the preschool license to serve 24 children from 2 years to entry into kindergarten in Room 51 only. The program operates Monday through Friday from 8:00 a.m. to 11:30 a.m.

AS observed one preschool classroom. AS measured room 51. The total classroom space contains a total of 921 square feet, which will accommodate Licensee's request for 24 preschool children. There are 4 toilets and 3 sinks for the children, and a separate private restroom for the staff. AS observed a Shared Bathroom Waiver in the facility file. Director stated there has been no changes to the outdoor activity space.

Director 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.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Esther Jackson.

The following item is required before the change of capacity will be approved:
1. Updated granted fire inspection report (STD850).
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022
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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