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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621291
Report Date: 12/20/2019
Date Signed: 12/20/2019 10:30:34 AM

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:VAN BUREN ELEMENTARY SCHOOLFACILITY NUMBER:
393621291
ADMINISTRATOR:RINGEN, IONEFACILITY TYPE:
850
ADDRESS:1628 E. TENTH STREETTELEPHONE:
(209) 933-7305
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY:24CENSUS: 20DATE:
12/20/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Teacher, Jennifer CraigTIME COMPLETED:
10:45 AM
NARRATIVE
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Licensing Program Analysts (LPA) Chayntel Hunter and Christopher Jackson met with Teacher, Jennifer Craig for the purpose of an unannounced Annual/Random inspection. LPAs toured the facility inside and out. LPAs observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility days and hours of operation are Monday-Friday from 8:00 AM to 11:30 AM. Facility provides breakfast which is supplied by the school cafeteria.

During today's inspection, LPAs observed staff role modeling appropriate classroom behaviors and interacting with children using appropriate tones and communication tactics. LPAs observed care and supervision of 20 preschoolers supervised by and interacting with 3 staff.

LPAs reviewed staffing ratios, first aid supplies, furniture, equipment, fire drills and drinking water. LPAs observed all required forms to be posted. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure appeared to be in good repair, and there is sufficient cushioning (wood chips) under the play structure.

LPAs reviewed the sign in/out book and observed that the children are properly signed in/out. All staff present during today's inspection have a fingerprint clearance through the Stockton Unified School District. LPAs observed that health screening reports and proof of immunization are centrally stored in an off site location. At least one staff member present during today's inpsection has current Pediatric CPR and First Aid. LPAs observed training certificate for approved third party mandated reporter training resource for all staff.

Report continues on 809-C.

SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: VAN BUREN ELEMENTARY SCHOOL
FACILITY NUMBER: 393621291
VISIT DATE: 12/20/2019
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LPAs checked that annual fees are current.

LPAs provided and discussed the Effects of Lead Exposure brochure.

This provider is not currently providing IMS services to children in care. 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

This facility evaluation report was reviewed and discussed with the Teacher. An exit interview was conducted. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. The Teacher was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

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

SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019
LIC809 (FAS) - (06/04)
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