393617273-5-17-2019-53-CC-SWIS-BC9P3Z-20190517105822

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393617273
Report Date: 05/17/2019
Date Signed: 05/17/2019 10:58:30 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:	PITTMAN ELEMENTARY		FACILITY NUMBER:	393617273
ADMINISTRATOR:	MACHADO, ADRIENNE		FACILITY TYPE:	850
ADDRESS:	701 E. PARK STREET		TELEPHONE:	(209) 933-1496
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95202
CAPACITY:	24	CENSUS: 20	DATE:	05/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:01 AM
MET WITH:	Carmela Martinez		TIME COMPLETED:	11:10 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 Analyst (LPA) Stacey Williams met with Carmela Martinez, Lead Teacher for the purpose of conducting an unannounced random annual inspection. LPA toured the facility including all activity and classroom spaces, restrooms, and outdoor play areas. Appropriate ratio and care and supervision were observed during today's inspection. Census included 20 preschool children supervised by three staff members. Lead Teacher was reminded never to exceed the conditions, limitations and capacity specified on the license. The facility operates in classroom C2 on the elementary school grounds. There are two half day programs. Hours of operation are Monday through Friday, 8:30 AM-11:30AM and 12:00 PM- 3:30 PM.

Classroom appeared clean including the carpets and floor. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under the climbing equipment are cushioned with enough material to absorb a fall. There are trees providing shade. Uncontaminated drinking water was readily available to children both indoors and outdoors. There are no firearms or bodies of water on the premises, and the facility has one functioning carbon monoxide detector. Trash cans containing solid waste had lids. LPA observed the classroom to have a first aid kit with the appropriate supplies. Classroom menu was posted. The facility provides breakfast and lunch. Children eat breakfast and lunch in the classroom. Required licensing documentation is posted on the bulletin board. LPA reviewed the sign/in-sign/out sheet. Toileting facilities are in safe, sanitary, and operating condition and there are enough sinks and toilets for the children in care. All cleaning supplies and medications were stored inaccessible to children in care and located in locked cabinets.

Report continues on subsequent page, LIC 809C

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

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: PITTMAN ELEMENTARY	FACILITY NUMBER: 393617273
	VISIT DATE: 05/17/2019

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

Selected staff and children's records were reviewed. All required documentation was observed in the files. Criminal Record clearances are associated to the facility license through the school district. At least one staff member present today has current Pediatric CPR and First Aid certification that expires July 2020. LPA observed a current children's roster and fire drill log with the last one conducted in April 2019.

Incidental Medical Services-IMS was discussed. LPA discussed IMS services and the requirement to update the plan of operation. For additional IMS information, LPA advised review of 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.

No Title 22 deficiencies cited in the areas evaluated during today's inspection.

This facility evaluation report was reviewed and discussed with Carmela Martinez, Lead Teacher. A notice of site visit was provided and should remain posted for a period of 30 days for parental review. LPA encouraged Lead Teacher to visit the department’s website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation. The implementation of AB 2370, lead exposure was discussed. A copy of this report will remain on file for a period of 3 years for public review upon request. Appeal rights were discussed and provided.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2