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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620684
Report Date: 03/01/2023
Date Signed: 03/01/2023 11:09:26 AM


Document Has Been Signed on 03/01/2023 11:09 AM - 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:JOAN RICHARDS LEARNING VILLAGEFACILITY NUMBER:
393620684
ADMINISTRATOR:CHRISTINA SHORTFACILITY TYPE:
850
ADDRESS:5211 BARBADOS CIRCLETELEPHONE:
(209) 461-2951
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:150CENSUS: DATE:
03/01/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Director: Denise TIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA) Mariya Melnichuk met with Director Denise Roblas for a Case Management inspection. The purpose of the inspection was to follow-up on a lead testing report dated 02/01/2023 which tested the water in the facility. LPA verified that all required adults have a clear background check by accessing guardian.

LPA was notified of the lead testing report which was dated 02/01/2023. The report revealed that one water outlet resulted in elevated levels of lead. Director stated that the outlet was an outdoor water hose bib not used for children. LPA verified that the outlet was taped off and not accessible for use.

An exit interview was conducted and the report was reviewed with Director .A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Mariya MelnichukTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2023
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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