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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393603371
Report Date: 04/27/2023
Date Signed: 04/27/2023 10:57:50 AM

Document Has Been Signed on 04/27/2023 10:57 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:NIGHTINGALE SCHOOL PRESCHOOLFACILITY NUMBER:
393603371
ADMINISTRATOR:KATHLEEN HAGANFACILITY TYPE:
850
ADDRESS:1721 CARPENTER ROADTELEPHONE:
(209) 933-7260
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY: 47TOTAL ENROLLED CHILDREN: 47CENSUS: 0DATE:
04/27/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:36 AM
MET WITH:Lead PM Teacher Trina Weeks-HernandezTIME COMPLETED:
11:20 AM
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On Thursday April 27, 2023 Licensing Program Analyst (LPA) Carla Polanco met with Lead PM Teacher, Trina Weeks-Hernandez in classroom #2 for a Case Management inspection. The purpose of the inspection was to follow up on a recent report of the lead testing in the facility of the water used for drinking and cooking. There were 14 children during the inspection.

During today's inspection LPA verified that the affected water outlets are not in use. The facility is using drinking water from an alternate water fountain that is not affected. Teacher stated that children are allowed to bring their own water bottles from home as well..



Due to a previous case management- lead testing/exceedance inspection conducted on February 16, 2023 in portable classroom #30 of the facility, that resulted in a type B citation, there are no deficiencies cited during today's visit.

A notice of site visit was posted by LPA and must remain posted for 30 days. Exit interview was conducted and the report was reviewed with Lead teacher Trina.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2023
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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