<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390317185
Report Date: 03/19/2025
Date Signed: 03/25/2025 09:51:06 AM

Document Has Been Signed on 03/25/2025 09:51 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:UNITED CEREBRAL PALSY OF SAN JOAQUIN CO.FACILITY NUMBER:
390317185
ADMINISTRATOR/
DIRECTOR:		CORINNE FIELDERFACILITY TYPE:
775
ADDRESS:134 PACIFIC ROADTELEPHONE:
(209) 239-3066
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY: 40CENSUS: 26DATE:
03/19/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Francisca OronaTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Unannounced Annual visit made out to this day program on 03/19/2025 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Francisca Orona, who was briefly interviewed at this time.
It was learned that this day program was vendorized through Valley Mountain Regional Center (VMRC) to accept and retain clients while maintaining a 3:1 ratio at all times.
Current census was 26 clients.
Tour of this day program was conducted.
Dining area, kitchen area, and all other areas designated for client use were observed to be furnished and maintained in compliance at this time.
All areas designated as classrooms, activity areas, and common areas for client use were toured. Furniture and furnishings were observed to be present and sufficient to meet the needs of the clients at this time.
Office rooms and other areas intended for client use were toured.
A review of the day program restrooms was conducted at this time.
Hot water temperatures were taken to make sure that the hot water being dispensed was within the allowed range of 105-120 degrees at all times.
Fire extinguishers, located throughout this facility, were observed to have been annually inspected on 06/26/2024 by the local fire extinguisher company, Butch Young Fire Company, and in compliance at this time.
Kitchen area was toured.
Kitchen drawers and cabinets were reviewed at this time.
The use of a microwave was observed to be present and in compliance at this time.
There was the presence of an oven and stove and were observed to be functional and in compliance at this time.
Facility food storage units, two refrigerators, were reviewed and observed to be functional and in good repair at this time.
NAME OF LICENSING PROGRAM MANAGER: Liza King
NAME OF LICENSING PROGRAM ANALYST: Charlie Yang
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2025
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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: UNITED CEREBRAL PALSY OF SAN JOAQUIN CO.
FACILITY NUMBER: 390317185
VISIT DATE: 03/19/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
It was learned that one refrigerator was used by the facility staff while the other was set aside for the clients.
Storage area for chemicals and cleaning supplies was observed to be locked and made inaccessible to the clients at this time.
Exterior grounds of this day program were toured at the rear area of this day program.
This facility was not enclosed with a facility perimeter fence, did not have any side gates, but did have a front gate area upon entering this day program which was observed to be functional and in good repair at this time.
A file review was conducted for the day program client files (5) at this time. These details were noted on the following LIC 858.
A file review was conducted for the day program staff (5) files at this time. These details were noted on the following LIC 859.

The following forms and documents were requested to be updated and submitted into CCL:
  • LIC 308

  • LIC 400

  • LIC 500

  • LIC 610


There were no deficiencies observed or cited during today's annual visit.

Exit Interview
NAME OF LICENSING PROGRAM MANAGER: Liza King
NAME OF LICENSING PROGRAM ANALYST: Charlie Yang
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025
LIC809 (FAS) - (06/04)
Page: 2 of 2