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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483008616
Report Date: 08/05/2019
Date Signed: 08/05/2019 01:57:49 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:BENICIA USD JOE HENDERSON PRESCHOOLFACILITY NUMBER:
483008616
ADMINISTRATOR:REGIS, JUNEFACILITY TYPE:
850
ADDRESS:650 HASTINGS DRIVETELEPHONE:
(707) 747-8367
CITY:BENICIASTATE: CAZIP CODE:
94510
CAPACITY:19CENSUS: 0DATE:
08/05/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:June RegisTIME COMPLETED:
09:30 AM
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Licensing Program Analyst (LPA) Glenn Ouye arrived and met with June Regis and Erica Dudley to conduct a case management visit for a licensee initiated capacity increase. The capacity increase application was received by Community Care Licensing on July 10, 2019.
The preschool used one classroom in the past. The preschool now has two classrooms which are side by side. An approved fire clearance has been received from the Benicia Fire Inspector on 8/2/2019.

Classroom's F1 and F2 were measured. There is adequate interior and exterior square footage to support the new capacity of 43 preschool children ages 2 years to 5 years old age range.

There are 3 toilets and 3 hand washing stations for the children. The smoke alarms are hardwired, the carbon monoxide detectors were tested and functional in each classroom. There were also fire extinguishers rated at a minimum of 2A10 BC in each classroom. There was sufficient chairs and tables and age appropriate toys for the children. Each room has locking cabinets where cleaning supplies and art supplies are stored. First aid supplies are stored in each classroom. Each classroom has a sign in and out log.

The outdoor play area is fully fenced and has two wood chips located under the outdoor play toys to cushion falls. The facility will maintain the use of a secured easy up as a shade area for the children who are using the outdoor play area.

The capacity increase from 19 to 43 children is approved as of August 5, 2019.gf
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2019
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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