393621111-8-17-2023-53-CC-CPRA-CUSTPM-20230817145434

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393621111
Report Date: 08/17/2023
Date Signed: 08/17/2023 02:54:40 PM

Document Has Been Signed on 08/17/2023 02:54 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:	SANTA FE - SUSD HEAD START		FACILITY NUMBER:	393621111
ADMINISTRATOR:	KELLER, DEBRA		FACILITY TYPE:	850
ADDRESS:	639 W. WORTH STREET		TELEPHONE:	(209) 565-5925
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95206
CAPACITY: 20	TOTAL ENROLLED CHILDREN: 20	CENSUS: 4	DATE:	08/17/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:47 PM
MET WITH:	Lead Teacher Ana Garza-Martin		TIME COMPLETED:	03:15 PM

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On 8/17/23, Licensing Program Analyst Carla Polanco Rivera (LPA), met with Lead Teacher Ana Garza-Martin, for the purpose of an unannounced Annual inspection. During today's inspection there were 4 children and two staff present during the start of the inspection. LPA toured the facility inside and out. Facility days and hours of operation are Monday- Friday 8:00 AM-2:00 PM. The facility is located inside a gated complex (Santa Fe Town Homes).

LPA reviewed care and supervision of children, staffing ratios and first aid supplies, furniture, equipment, fire drills and drinking water. There are adequate toys and equipment available for children. Outdoor play area was toured, the play area for the children appeared to be in good repair, there is sufficient cushioning under the play structures. Toileting facilities were in operating, safe, and sanitary condition. LPA observed all required forms to be posted. Food is provided by Edison High School. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPA reviewed the sign in/out book and observed that the children are properly signed in.

Staff and children's records were reviewed. Files reviewed contained an emergency card, immunization's and consent for medical treatment. At least one staff member present in each of the classrooms has current Pediatric CPR and First Aid certification, (Exp. 06/2024). All staff are currently employed through the District and have a criminal record clearance, mandated reporter certificates, and documentation of the educational background, training, and/or experience.

Report continues on LIC809-C.....

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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

FACILITY NAME: SANTA FE - SUSD HEAD START	FACILITY NUMBER: 393621111
	VISIT DATE: 08/17/2023

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LPA observed health screening reports with TB test and required MMR and TDAP vaccines for staff members. Staff is required to renew Mandated Reporter training every 2 years, training is available through the www.mandatedreporterca.com website.

Incidental Medical Services (IMS) policy was discussed. LPA reviewed storage of medication, and child personnel records. 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

Exit interview conducted and report was reviewed with Lead Teacher Ana Garza-Martin. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, no deficiencies were cited during the inspection.

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

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