394500016-7-8-2019-53-CC-MPOE-BDVQWS-20190708123227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500016
Report Date: 07/08/2019
Date Signed: 07/08/2019 12:32:38 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 - MCKINLEY (PS)		FACILITY NUMBER:	394500016
ADMINISTRATOR:	BALLARD, KIM		FACILITY TYPE:	850
ADDRESS:	1618 CHESTER DRIVE		TELEPHONE:	(209) 851-3479
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	24	CENSUS: 0	DATE:	07/08/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Cherryl Balatbat		TIME COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Mary Ponce and Marissa Soto met with Program Manager Cherryl Balatbat for the purpose of an announced pre-licensing inspection. Applicant requests a preschool license to serve 24 preschool children from two to six years of age. The program will operate Monday through Friday from 7:30 AM to 3:30 PM. LPA Ponce provided LIC311A. Applicant acknowledge that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat law, menus, and daily schedule. LPAs discussed the forms that must be in each child's and each staff member's file. Cherryl stated that the center will be using an Ipad for sign-in and sign-out. The software for the electronic signing process is through Child Plus. LPA advised Cherryl to ensure that sign in and sign out records are available to LPAs upon request during inspections. The program will be providing breakfast, lunch, and afternoon snack which will be brought to the center by Creative Childcare. The kitchen will be considered off limits and Cherryl stated that they will install a gate to prevent access by children. INDOOR ACTIVITY SPACE: The program has one large classroom area including library and writing area, manipulative, dramatic play area, eating area, art area, and science area which will be utilized by all children in care. There are 7 classrooms in the gated area including the CAPC preschool classroom labeled HS-1. LPAs observed 22 chairs and 4 tables meant for children. LPAs observed 17 napping cots and observed that they will be stored in the staff bathroom. Cherryl stated that three more napping cots will be delivered on 7/9/2019 This report continued on LIC809-C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Mary Ponce	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

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 - MCKINLEY (PS)	FACILITY NUMBER: 394500016
	VISIT DATE: 07/08/2019

NARRATIVE

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LPAs discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; criminal record clearances; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications, pesticide training, and maintaining buildings and grounds. LPAs provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so Applicant can request to be added to the distribution list to receive Quarterly Updates.

This facility evaluation report was reviewed and discussed with the Applicant. Cherryl was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

CONDITIONS REQUIRING CORRECTION PRIOR TO ISSUING A LICENSE:

1. A final review of the file by LPM Maria Mayorga.
2. Proof of at least 7 more napping cots.
3. Proof of installation for fridge and microwave.
4. Proof of 2 more chairs for children's use.
5. Proof of cubbies for 2 more children.
6. Proof of IMS plan (or Care plan).
7. Submission of shared space waiver, or letter from Mckinley Elementary school allowing use of all outside space.
8. Proof that the wasp nest by classroom B is removed
9. Proof of accessible water for outside play
10. Proof that the installed equipment is age appropriate for preschool children.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Mary Ponce	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

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 - MCKINLEY (PS)	FACILITY NUMBER: 394500016
	VISIT DATE: 07/08/2019

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bodies of water on the premises. There are shaded areas supplied by trees, canopies, and overhangs. During measurements, LPAs observed a wasp nest attached to the overhang of classroom B. Cherryl will show proof of removal prior to licensor.

The outdoor activity space was measured. Cherryl stated she is going to request use of the entire outside space including the second play structure dedicated for Mckinley Preschool. LPAs measured the outdoor space including the areas dedicated to Mckinley Preschool which contains 14,478.7662 square feet; accommodating the 24 children being requested.
The outdoor space dedicated to the CAPC preschool measures at 6, 218.40576 square feet which will also accommodate the 24 requested children. Cherryl stated she will request a letter from Mckinley Elementary giving permission for the CAPC preschool to utilize the entire outside space and not just the space dedicated to CAPC. If a letter can not be obtained Cherryl stated she will provide a waiver request for shared outdoor space along with a schedule for both programs and will place cones outside and positioning of staff to ensure that children do not utilize the Mckinley Preschool play equipment. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). LPAs did not observe a functional water fountain outside. Cherryl stated she will use a water pitcher and cups that will be accessible to children.

Incidental Medical Services and a Plan of Operation will be provided to licensing prior to licensor. 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. Cherryl stated that the program uses the "Care Plan" which is used through Head start. 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.

report continued on LIC809-C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Mary Ponce	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

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 - MCKINLEY (PS)	FACILITY NUMBER: 394500016
	VISIT DATE: 07/08/2019

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and will provide LPA with a copy of the shipment order prior to licensor or proof of delivery. The refrigerator and microwave will be delivered on July 22nd. Cherryl will provide LPA pictures of installed fridge and microwave prior to licensor. Currently, the facility has a dishwasher and a sink in the kitchen. Food for meals and snacks will be stored in the kitchen. There is a first aid kit that will be kept in the classroom on the wall near the door. Medications will be stored in the cabinet above the hand washing station in the classroom and will be labeled "Medication". LPAs did not observe cleaning disinfectants; however Cherryl stated that they will be stored in a cabinet above the hand washing station. Cherryl also stated that they utilize a janitorial service to clean every night Mon-Fri. Cherryl stated there are no poisons on the premises. LPAs observed cubby space for 22 children. Cherryl stated they will order cubbies for 2 more children. LPAs observed a water fountain indoors which will be used by children in care.

LPAs measured all classroom space. The classrooms contains a total of 1,056.28 square feet, which will accommodate the applicant's request for 24 preschool children. There are 2 toilets and 2 sinks for the children and a separate private restroom for the staff. Children who become ill during the day will be isolated in the office and will have a padded mat to lay on when needed.

OUTDOOR ACTIVITY SPACE:
The outdoor space is in the courtyard area near the preschool classrooms. Both the program and the outdoor space are enclosed together by a chain-linked fence that is at least 4 feet tall. The outdoor area has one play structure that is dedicated to CAPC, and another play structure that is dedicated to the Mckinley preschool. The play structure dedicated to the Mckinley preschool program is labeled for children ages 2-12 years old. The play structure dedicated to CAPC does not have a label on the play structure; however it was installed through SJCOE (San Joaquin County of Education) through Head Start. Cherryl will provide proof that the play structure is approved for children ages 2-5 prior to licensor. There are no firearms or

This report continued on LIC 809-C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Mary Ponce	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

LIC809 (FAS) - (06/04)

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