393622010-9-21-2021-53-CC-ESIA-C73SP6-20210921140238

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393622010
Report Date: 09/21/2021
Date Signed: 09/21/2021 02:02:45 PM

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 - SBS IW (INF)		FACILITY NUMBER:	393622010
ADMINISTRATOR:	TURNER-HARDIN, LINDY		FACILITY TYPE:	830
ADDRESS:	540 N. CALIFORNIA STREET		TELEPHONE:	(209) 644-5311
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95202
CAPACITY:	27	CENSUS: 8	DATE:	09/21/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Aronie Warren		TIME COMPLETED:	02:10 PM

NARRATIVE

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On Tuesday September 21, 2021, at 11:00 AM Licensing Program Analysts (LPA) Elvira Sierra met with Facility Representative Aronie Warren for an unannounced annual random inspection. LPA observed 8 infants supervised by 4 staff. Facility operates in the Central Sandra Bultler Smith building in classrooms EHS and the infant Waddler classroom from Monday through Friday from 07:00 am to 5:30 pm. Facility Representative was reminded never to exceed the conditions, limitations and capacity specified on the license.

LPA toured all activity and classroom spaces, restrooms, and outdoor play areas .Facility Representative stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. Toileting and diapering facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. Facility provides breakfast, lunch, and afternoon snack, which are provided by the centralized kitchen located at Central site. There is no kitchen in the classroom, but there is a fridge where additional food is stored. Menus are posted and drinking water is readily available to children both indoors and outdoors. There are no firearms or bodies of water on the premises. LPA observed a functional carbon/ monoxide monoxide detector and a fully charged fire extinguisher that meets regulations. LPA reviewed the Department's inspection authority and discussed with Facility Representative any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days. LPA observed sign-in and sign-out sheets and were complete.

4 staff and 8 infants’ records were reviewed. Each child's file contained an emergency card and a sleeping log. At least one staff member present today has current Pediatric CPR and First Aid certification. All staff currently employed with the facility have a criminal record clearance, health screening report, mandated reporter certificates, and documentation of the educational background, training, and/or experience.

Report continues on 809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

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 - SBS IW (INF)	FACILITY NUMBER: 393622010
	VISIT DATE: 09/21/2021

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Incidental Medical Services (IMS) policy was discussed. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

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.

In the areas that were evaluated, no deficiencies were cited on today’s date. Exit interview was conducted and report was reviewed with Facility Representative, Aronie Warren. A Notice of Site Visit was provided and should remain posted for a period of 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

LIC809 (FAS) - (06/04)

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