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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393622598
Report Date: 05/30/2023
Date Signed: 05/30/2023 12:53:42 PM


Document Has Been Signed on 05/30/2023 12:53 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:CHIMINIKE'S PRESCHOOL LEARNING CENTER - LLCFACILITY NUMBER:
393622598
ADMINISTRATOR:PICOS, MERARYFACILITY TYPE:
850
ADDRESS:6608 GRIGSBY PLACETELEPHONE:
(209) 451-0583
CITY:STOCKTONSTATE: CAZIP CODE:
95219
CAPACITY:40CENSUS: 35DATE:
05/30/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Merary PicosTIME COMPLETED:
01:00 PM
NARRATIVE
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On May 30th, 2023, at 9:30 am, Licensing Program Analysts (LPAs), Lauren Scott and David Nguyen conducted an announced field visit to the facility. LPAs arrived at the facility and was met by Director Merary Picos (D1). LPAs disclosed the purpose of the inspection and were granted entrance into the facility. LPAS requested to review the electronic sign-in and sign-out sheets. Once reviewed, LPAs observed 24 children signed in. Based on observation and record view, facility did not ensure daycare children are signed in properly, which poses potential health, safety or personal rights risk to persons in care.

A Type B violation was assessed on a subsequent 809-D page. An exit interview was conducted, and the report was reviewed with D1. Licensee Appeal Rights were provided to D1. A Notice of Site visit was posted by LPA 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: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: David NguyenTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2023
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


Document Has Been Signed on 05/30/2023 12:53 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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833


FACILITY NAME: CHIMINIKE'S PRESCHOOL LEARNING CENTER - LLC
FACILITY NUMBER: 393622598

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2023
Section Cited
CCR
101229.1(b)

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Sign In and Sign Out
The person who brings the child to, and removes the child from, the center shall sign the child in/out.
This requirement was not met as evidenced by:
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The facility will ensure the parents sign their children in prior to parents leaving their children at the facility.
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LPAs only observed 24 children signed in. Based on observation and record view, facility did not ensure daycare children are signed in properly, which poses an potential health, safety or personal rights risk to persons in care.
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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: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: David NguyenTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2