393620856-1-25-2023-53-CC-SWIS-CNEUPY-20230125144620

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393620856
Report Date: 01/25/2023
Date Signed: 01/25/2023 02:46:30 PM

Document Has Been Signed on 01/25/2023 02:46 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	FRANKLIN HIGH SCHOOL		FACILITY NUMBER:	393620856
ADMINISTRATOR:	REYES, AILEEN		FACILITY TYPE:	850
ADDRESS:	4600 E. FREMONT STREET		TELEPHONE:	(209) 933-7435
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95215
CAPACITY:	20	CENSUS: 14	DATE:	01/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Rattanavy Khuon		TIME COMPLETED:	02:55 PM

NARRATIVE

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On January 25, 2023, at approximately 9:45AM Licensing Program Analyst (LPA) Stacey Williams met with Facility Representative for the purpose of an unannounced required- 1 year inspection. Program operation hours are Monday through Friday 8:00AM-2:00PM. Upon arrival, LPA observed fourteen (14) children supervised by three staff. Criminal record clearances are conducted through the school district.

LPA conducted a health and safety inspection for all areas accessible to children. Staff stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. LPA observed a functional smoke/carbon monoxide detector and a fully charged 2A :10BC fire extinguisher. The floors appeared clean throughout the facility. Outdoor play area is free from dangerous conditions and playground equipment is securely anchored to the ground. Facility uses rubber padded matting under the play equipment to absorb falls. Program provides breakfast and lunch. Meals are provided through the school district. Menus were posted in the entry of the facility. Facility utilizes drinking water from the sink faucet (indoors) and two water fountains (outside play structure). LPA discussed lead testing requirements of accessible water with the facility representative. Sign in/out sheets were reviewed. Each child has individual clipboards for sign in/out sheets.

Child files were reviewed. Each child’s file included information pertaining to their authorized representative, consent for medical treatment, immunization records, and a medical assessment form. Files for staff who were present at the facility were reviewed. Staff have a criminal record clearance through Stockton Unified school district. Mandated Reporter training completion certificates are from Keenan and Associates. Health screening report, immunization records, and documentation of their educational background, training, and/or experience was verified in files. File review revealed that staff #2 does not have mandated reporter training on file. CPR/ First Aid certification was verified for staff present. Lead Teacher has a CPR/First Aid expiration date of 11/2023.

Report continues on LIC 809-C

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

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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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: FRANKLIN HIGH SCHOOL	FACILITY NUMBER: 393620856
	VISIT DATE: 01/25/2023

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LPA reviewed the Department's inspection authority and discussed with staff any changes that may occur regarding Director/Site Supervisor or an employee acting in the director's absence must be reported to department within 10 working days.

Per facility representative there are children that have IMS service plan on file. Facility has an Incidental Medial Service Plan on file. Incidental Medical Services (IMS) policy was discussed. 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 at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Title 22 deficiencies were observed during this inspection and cited on subsequent page, LIC 809D.

LPA reviewed report with the Facility Representative, Rattanavy Khuon and provided copies of the report along with Appeal Rights.

A notice of site visit was provided and posted by LPA Williams 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: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/25/2023 02:46 PM - It Cannot Be Edited

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: FRANKLIN HIGH SCHOOL	FACILITY NUMBER: 393620856
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 3 staff files.Staff reported they are new and was hired on 10/11/2022. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/24/2023
	Plan of Correction
1 2 3 4	Staff #2 will complete mandated reporter training and submit a copy of the certificate to CCL by POC date- 2/24/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

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