393617273-9-1-2023-53-CC-ESIA-CV9THV-20230901144523

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393617273
Report Date: 09/01/2023
Date Signed: 09/01/2023 02:45:28 PM

Document Has Been Signed on 09/01/2023 02:45 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	PITTMAN ELEMENTARY		FACILITY NUMBER:	393617273
ADMINISTRATOR:	EMILIO JUNEZ		FACILITY TYPE:	850
ADDRESS:	701 E. PARK STREET		TELEPHONE:	(209) 933-1496
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95202
CAPACITY:	24	CENSUS:	DATE:	09/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:			TIME COMPLETED:	03:00 PM

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	On 09/01/23, Licensing Program Analyst (LPA), Elvira Sierra, met with Facility Representative, Angela Luna for an unannounced annual inspection. Facility operates inside the Pittman Elementary School campus in classroom C-2. Facility is a State funded preschool that operates M-F part day from 08:00am to 11:00am and 12:00pm to 03:00pm. Facility follows school district calendar year. Present in the facility were three staff supervising 16 children. Facility was inspected indoors and outdoors for Health and Safety hazards and the following was observed; Facility appeared clean including the carpets and floor. Classroom has age-appropriate toys and equipment that are in good repaired. Classroom is adequately ventilated/heated. Facility representative stated that currently there are no children that required medication. Cleaning products and toxins are maintained inaccessible to children. Restrooms are maintained clean, in good repair and with adequate supplies. Staff use a separate restroom. Solid waste vessels have tight-fitting covers on, are in good repair. The isolation area for ill children is in the quiet area in the classroom and the use of the staff restroom if needed. Facility has a fire extinguisher that meets the minimum requirements, a working smoke, and a carbon monoxide detector. Outdoor play area is fenced for supervision. Facility has an approved waiver for shared playground with school age children. Facility representative stated that play structure in the playground is not use by the preschool children due to not be age appropriate. Shade area is provided by trees and building connected overhead. LPA observed water accessible to children by water fountains. First Aid Kit and Emergency supplies are available stored in the kitchen in an upper cabinet. Emergency Drill are conducted monthly and are properly logged. Facility provides full breakfast for the morning class and lunch for the afternoon class and snacks if needed. All posting requirements has been met. LPA reviewed five children and two staff files. LPA observed current CPR/ First aid card for staff and facility sign in and out sheets were reviewed. Report continues on subsequent page 809C--

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: PITTMAN ELEMENTARY	FACILITY NUMBER: 393617273
	VISIT DATE: 09/01/2023

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

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with the Facility Representative, Angela Luna. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2