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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701332
Report Date: 02/21/2024
Date Signed: 02/21/2024 02:07:46 PM

Document Has Been Signed on 02/21/2024 02:07 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CENTRAL VALLEY TRAINING CENTER STOCKTON EASTFACILITY NUMBER:
392701332
ADMINISTRATOR:PELLETIER, CANDICEFACILITY TYPE:
735
ADDRESS:7209 TAM O'SHANTER DRIVETELEPHONE:
(209) 490-4666
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 150CENSUS: 0DATE:
02/21/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Candice PelletierTIME COMPLETED:
02:10 PM
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On 2-21-24 at 1:00pm, Licensing Program Analyst (LPA) Michael Bilger arrived at this location to conduct a pre-licensing visit for a change of location. LPA met with Administrator Candice Pelletier and Regional Director Jennifer Jones. Facility is seeking approval for a change of location from current address 7333 Tam O' Shanter Dr, Stockton, CA. 95210. Upon entry LPA observed facility to have 4 classrooms and 5 offices. LPA further observed these spaces did not contain furniture and other supplies necessary for day program function at this time. It was learned that furniture and other supplies from other location will be moved to new location by 3-4-24.

As a result, facility change of location is not approved at this time. LPA will return at a later date to complete the pre-licensing inspection.

An exit interview was conducted with Candice Pelletier and a copy of this report was provided to Candice.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2024
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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