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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620824
Report Date: 11/10/2021
Date Signed: 11/10/2021 10:28:20 AM

Document Has Been Signed on 11/10/2021 10:28 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:CAPC RIPONAFACILITY NUMBER:
393620824
ADMINISTRATOR:GARCIA, JANELIFACILITY TYPE:
850
ADDRESS:415 OREGON STREETTELEPHONE:
(209) 559-2131
CITY:RIPONSTATE: CAZIP CODE:
95366
CAPACITY: 22TOTAL ENROLLED CHILDREN: 16CENSUS: 0DATE:
11/10/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kim Pawlowicz, Blanca Noriega, Janeli GarciaTIME COMPLETED:
11:00 AM
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Application Specialist (AS) Alecia Sifuentes met with Director of Early Education, Kim Pawlowicz, Program Manager, Blanca Noriega, and Center Manager, Janeli Garcia for the purpose of an announced case management inspection. Licensee requests a classroom and playground change to portable 218. Licensee is not making any changes to the capacity. The facility's hours of operation are Monday through Friday from 7:30 a.m. to 4:30 p.m. The granted fire clearance was received on 10/27/2021.

INDOOR ACTIVITY SPACE:
A health and safety inspection was conducted in all areas accessible to children. There is one preschool classroom. AS measured classroom portable 218. The total classroom space contains a total of 1,006 square feet, which will accommodate the current capacity of 22 preschool children. There are two toilets and three sinks available to children, and a separate staff restroom is available. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). AS observed a functional smoke and carbon monoxide detectors in the classroom. AS observed disinfectants are inaccessible and appropriately stored.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a chain link fence that is at least four feet tall and separates the preschool yard from the elementary school yard. AS observed a sufficient amount of equipment and toys. The play structure includes a safety label, which designates use for children 2 to 5 years old. There are no bodies of water on the premises. There are shaded areas supplied by trees and overhangs. AS measured the outdoor activity space. The outdoor play area contains a total of 3,963 square feet, which will accommodate Licensee's request for 22 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Report continues on LIC809-C.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2021
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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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: CAPC RIPONA
FACILITY NUMBER: 393620824
VISIT DATE: 11/10/2021
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This facility provides Incidental Medical Services – IMS. For IMS information see 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.

This facility evaluation report was reviewed and discussed with Licensee. Licensee was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

Effective today, 11/10/2021, AS will approve the facility’s classroom change for the preschool license.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
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