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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500417
Report Date: 03/16/2022
Date Signed: 03/16/2022 11:37:50 AM


Document Has Been Signed on 03/16/2022 11:37 AM - It Cannot Be Edited

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:ACHIEVERSFACILITY NUMBER:
394500417
ADMINISTRATOR:KOHLI, DIVYAFACILITY TYPE:
840
ADDRESS:4453 PRECISSI LANETELEPHONE:
(209) 956-5437
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:14CENSUS: 4DATE:
03/16/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Divya Kohli & Neeru VermaniTIME COMPLETED:
12:00 PM
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Application Specialist (AS) Alecia Sifuentes met with Licensees, Divya Kohli and Neeru Vermani for the purpose of an announced case management inspection. Licensee requests a classroom change, shared indoor space waiver, and first and last hour of the day waiver. Licensee is requesting for school-age room 1 to now be preschool room 4 and the multipurpose room and school-age room 2 to be one whole room shared amongst the preschool and school-age children. Licensee is not making any changes to the capacity. The program operates Monday through Friday from 6:30 a.m. to 6:00 p.m.

AS remeasured the multipurpose room. The total classroom space contains a total of 1,055 square feet, which will accommodate Licensees current capacity of 14 school-age children. There are 2 toilets and 2 sinks available to children, and a separate staff restroom is available. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Licensee 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.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensees, Divya Kohli and Neeru Vermani.

Effective today, 3/16/2022, AS will approve the request to add the multipurpose room to the school-age license.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:
DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2022
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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