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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393614120
Report Date: 09/01/2021
Date Signed: 09/01/2021 02:00:10 PM

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:MANTECA CHRISTIAN PRESCHOOLFACILITY NUMBER:
393614120
ADMINISTRATOR:CONTE, RHONDAFACILITY TYPE:
850
ADDRESS:486 BUTTON AVETELEPHONE:
(209) 825-1095
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY:120CENSUS: 41DATE:
09/01/2021
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Alicia WebsterTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Christopher Jackson met with facility representative Alicia Webster for the purpose of an unannounced random annual inspection on 09/01/21. There were 41 pre-school children and 6 staff present. All staff have been finger printed and cleared through Community Care Licensing and are associated to the facility. The facility operates in classrooms #7, #8-1/2, #9, #10, and #11 on the grounds of the Refuge Church. The program operates Monday thru Friday from 6:30 AM to 6:00 PM.

LPA toured the facility inside and out for a health and safety inspection. The facility is organized into defined areas for children to engage in activities. LPA did observed the toys to not have any broken pieces or sharp edges. All cleaning supplies and hazardous items are stored in secured cabinets making them inaccessible to children in care. Restroom are sanitary and in operating condition. Trash containers for solid waste have lids. Drinking water was readily available inside and outside. Staff stated that portable jugs of water are used for the children when doing outside play. The playground equipment and outdoor activity space is maintained and in good condition. Wooden chips are being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. LPA discussed the requirement to conduct fire drills at least once every six months. Carbon Monoxide, fire extinguisher and smoke detectors were present and meet regulation.

The program provides snack for children in care. Breakfast and lunches are provided by parents. LPA observed menus posted in the parent area. Food preparation area is clean, food is protected from contamination, and all food or beverages are stored in covered containers and labeled.

Report Continues on 809-C

SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021
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: MANTECA CHRISTIAN PRESCHOOL
FACILITY NUMBER: 393614120
VISIT DATE: 09/01/2021
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Visual supervision for indoor and outdoor activities was observed during today's inspection. Capacity and ratio requirements are being met. LPA reviewed eight children’s files during today's inspection and observed the included information pertaining to their Emergency information, immunization records, Parents Rights and Personal Rights. LPA reviewed three Staff records during today's inspection. LPA observed the files included information regarding current CPR/First Aid for at least one staff member on site, which expires on 10/2022. In addition LPA observed immunization records and documentation of the educational background, training, and/or experience. LPA also observed mandated training certificates in staff files.

This facility currently does not provide Incidental Medical Services- IMS. LPA discussed storage of medication and equipment/supplies. 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 observed no expired medication at time of inspection and proper authorization forms.



LPA provided the Community Care Licensing website www.ccld.ca.gov, so the facility representative can obtain updated licensing information, new regulations and access forms. LPA advised facility representative of their responsibility to stay current in regards to new regulations.

No Title 22 deficiencies were observed in the areas that were evaluated today. A Notice of Site Visit was posted and must remain posted for a period of 30 days. An exit interview was conducted with licensing representative Alicia Webster.
SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021
LIC809 (FAS) - (06/04)
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