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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500030
Report Date: 12/23/2020
Date Signed: 12/23/2020 04:07:54 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 - GREAT VALLEYFACILITY NUMBER:
394500030
ADMINISTRATOR:CARTER, STACEYFACILITY TYPE:
850
ADDRESS:4223 MCDOUGALD BLVDTELEPHONE:
(209) 851-3479
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY:48CENSUS: 0DATE:
12/23/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:03 PM
MET WITH:Laprice BrownTIME COMPLETED:
03:19 PM
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Due to the COVID-19 pandemic Licensing Program Analyst (LPA) Fabiola Diaz is conducting a telephone call with Program Director Laprice Brown. The reason for the telephone call is to discuss the shared outdoor playground. A waiver is not needed for the shared outdoor playground with the two other preschool facilities: Preschool for All @ Great Valley and the Special Education classrooms from the San Joaquin County Office of Education. LPA and Program Director discussed the safe usage of the shared playground, maintaining ratios, and outdoor equipment.

An exit interview was conducted. A copy of this report was e-mailed to Program Director to keep on file at the facility. A “read receipt” and/or an e-mail from Program Director stating Program Director has read and reviewed this report is in lieu of a signature due to COVID-19. Program Director stated she is also able to sign the report.

SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola DiazTELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020
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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