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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503810113
Report Date: 07/18/2020
Date Signed: 07/18/2020 12:45:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CCCDS - RIVERBANK CHILD DEVELOPMENT CENTERFACILITY NUMBER:
503810113
ADMINISTRATOR:ALVAREZ, CONCHAFACILITY TYPE:
830
ADDRESS:6200 CLAUS RDTELEPHONE:
(209) 863-8663
CITY:RIVERBANKSTATE: CAZIP CODE:
95367
CAPACITY:18CENSUS: 0DATE:
07/18/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Concha AlvarezTIME COMPLETED:
10:45 AM
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On 07/18/2020, Licensing Program Analysts (LPAs) Juvenal Moctezuma and Claudia Henley conducted an announced prelicensing inspection and met with Executive Director, Concha Alvarez and Administrative Supervisor, Beatriz Diaz. LPA explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located at 6200 Claus Road in Riverbank, CA. The licensee is requesting an Infant license with a capacity of 18 infants, including up to 4 crib babies. This program operates from April to December from Monday through Friday 7:00 AM to 5:00 PM. This program will operate in classroom number #6. Licensee will provide formula, breakfast, lunch, and snack. The meals will be prepared by staff on site and eaten in the classroom. There is a sink with hot water inside kitchen area that will be used for food preparation. Ill children and staff will utilize the bathroom located near the office. Ill children will be isolated in the office. A working carbon monoxide is installed.

Room #6’s measurements were taken and reviewed with Concha. The total inside infant area is an approximate 654 square feet which will accommodate the requested capacity of 18 infants. LPA observed the crib area available, which can accommodate 4 crib infants and 8 sleeping cots. The refrigerator for infant formula, bottles, and infant food, is in the kitchen. Custodian will be going in and out of the kitchen to warm up and bring the infants food. There is a changing table with cushioning and 3" sides within arm’s length from a sink. This sink will not to be used for food preparation. Concha will submit pictures of adequate storage space for children's belongings. Outdoor storage is available for toys and equipment. Outdoor measurements were taken on this date for the infant playground and totaled to an approximate 2,967 square feet which exceeds the requested capacity for 18 infants. Infant playground will only be used for infants. Concha stated she will get a pop up shade structure to provide more shade. The Licensee is currently utilizing a tree for shade. The infant program does not provide toilet training. There is no climbing equipment in the infant outside play yard.

A fire clearance for 18 infants was received and approved from the Stanislaus Consolidated Fire Protection District on 06/03/2020.



Continued on next page LIC 809-C
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CCCDS - RIVERBANK CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 503810113
VISIT DATE: 07/18/2020
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. 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

The following items must be completed prior to issuing a license by 08/01/20:


1. 2 additional spaces for children's belongings (cubbies).
2. Get pop up shade structure to provide more shade in the infants play yard.
3. Repair the leak in the water faucet that's located next to the changing table.
4. Outdoor sketch revised
5. An updated LIC 500
6. The Original Financial Information Release & Verification LIC 404.

Pending a final file review and completion of the above listed items, a recommendation will be made to license the above facility for a capacity of 18 infants.

The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Activity Schedule
* Lead Poisoning brochure
* Shaken Baby brochure
* Safe Sleep Brochure

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2