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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393604033
Report Date: 12/07/2023
Date Signed: 12/07/2023 12:02:39 PM

Document Has Been Signed on 12/07/2023 12:02 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:COLONIAL HEIGHTS STATE PRESCHOOLFACILITY NUMBER:
393604033
ADMINISTRATOR:ARDELEAN, GRETCHENFACILITY TYPE:
850
ADDRESS:8135 BALBOA AVENUETELEPHONE:
(209) 953-8734
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY: 24TOTAL ENROLLED CHILDREN: 20CENSUS: 19DATE:
12/07/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Rena DameleTIME COMPLETED:
12:15 PM
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On 12/07/23, Licensing Program Analyst (LPA) Elvira Sierra met with Preschool Specialist, Rena Damele for the purpose of an unannounced annual inspection. Facility representative was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility is a child development program funded by the California Department of Education and operating under Title 5. Facility operates inside the Colonial Heights Campus in classroom #6. The facility operate Monday through Friday under two part-day programs from 8:00 AM to 11:00 AM and 12:00 PM to 3:00 PM. Facility follows the school calendar year. Census include 19 children being supervised by three staff members. Facility's fingerprint clearances for staff are conducted through the school district.
LPA conducted a health and safety inspection in all areas accessible to children and the following was observed; Appropriate ratio and care and supervision were observed during today's inspection. Classroom is adequately ventilated/heated. LPA observed age-appropriate toys and equipment that are in good repair. Toxic and hazardous items were inaccessible to children. LPA observed functioning carbon/monoxide detectors and a 2A10BC fire extinguisher that follows California State Fire Marshall standards. Per facility representative there are no poisons on the premises and no bodies of water were observed. The floors appeared clean throughout the facility. There are 2 toilets and 3 sinks available for the preschool children. Staff uses a separate bathroom. Toileting facilities were observed in safe, sanitary, and operating condition. First Aid Kit and Emergency supplies are available and stored inaccessible to children. Drinking water is readily available indoor and outdoor. Per facility representative children bring their own bottled water from home and staff refills the bottle if needed. Outdoor play area is shared with the kindergarten students and was observed to be free from dangerous conditions.
Program does not provide napping. Program provides breakfast, lunch and afternoon snacks that is prepared by the Child Nutrition department following the State guidelines. Menus were posted in the classroom.
All posting requirements has been met. Facility conduct fire emergency drills monthly. LPA reviewed five children and three staff files, current CPR/ First aid card for staff were observed. Facility sign in/out book was reviewed.

Report continues on subsequent page 809C-

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2023
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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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: COLONIAL HEIGHTS STATE PRESCHOOL
FACILITY NUMBER: 393604033
VISIT DATE: 12/07/2023
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Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.Incidental Medical Services (IMS) policy was discussed.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.


Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility Representative, Rena Damele.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC809 (FAS) - (06/04)
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