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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393616648
Report Date: 02/14/2020
Date Signed: 02/14/2020 01:31:55 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 PARKS & REC., KIDS ZONE - STELLA BROCKMANFACILITY NUMBER:
393616648
ADMINISTRATOR:LOMA, VICTORIAFACILITY TYPE:
840
ADDRESS:763 SILVERADO DRIVETELEPHONE:
(209) 456-8600
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY:90CENSUS: 9DATE:
02/14/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Chris BreitenbucherTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Alecia Sifuentes met with Recreational Coordinator Chris Breitenbucher, Program Coordinator Jennifer Hooper, and Teachers Brenda Silva and Magdalena Hernandez for the purpose of an unannounced annual random inspection. Census included nine children being supervised by two staff members. Facility hours of operation are Monday through Friday from 6:30 a.m. to 8:45 a.m. and 12:30 p.m. to 6:00 p.m.

LPA toured all activity and classroom spaces, restrooms, and outdoor play areas. Medications are stored appropriately in the kitchen and are inaccessible to children. Toxic and hazardous items are located in a locked cabinet in the staff restroom and inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under climbing equipment is cushioned with soft top to absorb the fall. Toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers. Program provides morning snack and afternoon snack. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPA observed full legal signatures while reviewing the sign-in and sign-out sheet.

Two staff and four children's records were reviewed. Each child's file contained an emergency card and a consent for medical treatment. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 8/5/2021). All staff currently employed with the facility have a criminal record clearance, health screening report, and documentation of the educational background, training, and/or experience. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector.

Report continues on 809-C.

SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
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 PARKS & REC., KIDS ZONE - STELLA BROCKMAN
FACILITY NUMBER: 393616648
VISIT DATE: 02/14/2020
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The facility's Plan of Operation is located in the facility file. Incidental Medical Services (IMS) policy was discussed. IMS is provided by this facility. 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 athttp://www.ada.gov/childqanda.htm.

This facility evaluation report was reviewed and discussed with Recreational Coordinator. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. Director was encouraged to the visit the department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov.



In the areas that were evaluated, no deficiencies were observed at the time of the visit.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
LIC809 (FAS) - (06/04)
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