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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500259
Report Date: 09/22/2020
Date Signed: 09/22/2020 10:41:54 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:SWAINFACILITY NUMBER:
394500259
ADMINISTRATOR:SAR CHHINFACILITY TYPE:
850
ADDRESS:2020 W. SWAIN ROADTELEPHONE:
(209) 953-8094
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:24CENSUS: 0DATE:
09/22/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Rena DameleTIME COMPLETED:
10:00 AM
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Application Specialist (AS) Seychelle De Luca and Licensing Program Analyst (LPA) Gagandeep Singh met with Preschool Specialist Rena Damele for the purpose of a second announced prelicensing change of location tele-inspection (due to COVID-19).

The restroom partitions have been installed. Preschool Specialist remeasured the classroom; and AS walked her through the measuring process. The total classroom space contains a total of 816.5223 square feet, which does not accommodate the request for 24 preschool children. The space measures for 23 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

This facility evaluation report was reviewed and discussed with Director. AS emailed a copy of the 809 to Preschool Specialist. Preschool Specialist understands she must reply to the email that she received, read, and understands the report.

CONDITIONS REQUIRING CORRECTION PRIOR TO ISSUING A LICENSE:
1. Updated application for 23 children.
2. Updated fire clearance for 23 children.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2020
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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