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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390320654
Report Date: 07/16/2026
Date Signed: 07/16/2026 12:00:22 PM

Document Has Been Signed on 07/16/2026 12:00 PM - 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ST. ANTHONY'S PRESCHOOLFACILITY NUMBER:
390320654
ADMINISTRATOR/
DIRECTOR:		JENNIFER DALENFACILITY TYPE:
850
ADDRESS:323 NORTH FREMONT AVENUETELEPHONE:
(209) 823-3959
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY: 45TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/16/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Jennifer DalenTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
NARRATIVE
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On July 16, 2026, Licensing Program Analysts (LPAs) Deborah Khashe and Sarah Tibbett met facility representative Jennifer Dalen for a change of capacity. The facility representative has requested a decrease in capacity from 45 children that used room G1 and room 11. Facility representative Jennifer Dalen has requested to only serve total capacity of 15 preschool children age 2 years to entry into kindergarten or first grade. The children will be in classroom G1. Classroom 11 will no longer be apart of St. Anthony licensed preschool.

INDOOR ACTIVITY SPACE:

The total classroom space in room G1 contains a total of 525 square feet which will accommodate the licensee’s request. There is 1 toilet and 1 sink for the children. There is a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

OUTDOOR ACTIVITY SPACE

On July 17, 2017, a playground waiver was granted for the preschool children to use the St. Anthony’s Catholic School playground on the school site, the conditions are as follows:

1. The programs maintain the agreement by using specified schedule to ensure all parties have a clear understanding as to what class is utilizing the playground.

2. There shall never be commingling of children from elementary school and preschool program.

3. The outdoor play structures and equipment shall be age appropriate for preschool children use.

RESTROOMS

Report Continues on LIC 809C....

Karyn Guerra
Deborah Khashe
DATE: 07/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ST. ANTHONY'S PRESCHOOL
FACILITY NUMBER: 390320654
VISIT DATE: 07/16/2026
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On July 17, 2017, a restroom waiver was granted for preschool children share a restroom with St Anthony’s elementary school children. the following conditions are as follows:

1. Preschool children must be accompanied to and from the restroom by a facility member.

2. The center shall maintain proper teacher-child ratio at all times.

3. Staff shall ensure adequate supervision of the preschool children while inside the restroom.

4. The staff ensure the restroom is clean and sanitary prior to use.

The department received the approved fire clearance from the Manteca Fire Department dated 06/10/26 . Licensee has met all requirements for the Change of Capacity. As of today's date, 07/16/26, licensee capacity is decreased from 45 children to 15 preschool children age 2 yrs to entry into kindergarten or first grade.

Exit interview conducted with Jennifer Dalen and appeal rights provided.

NAME OF LICENSING PROGRAM MANAGER: Karyn Guerra
NAME OF LICENSING PROGRAM ANALYST: Deborah Khashe
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026
LIC809 (FAS) - (06/04)
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