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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393605949
Report Date: 02/20/2025
Date Signed: 02/20/2025 03:01:30 PM

Document Has Been Signed on 02/20/2025 03:01 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TRACY UNIFIED SCHOOL DISTRICT SOUTH/WEST PARK ELEMFACILITY NUMBER:
393605949
ADMINISTRATOR/
DIRECTOR:		GARCIA, ROCIOFACILITY TYPE:
850
ADDRESS:500 WEST MOUNT DIABLO AVETELEPHONE:
(209) 830-3355
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 27DATE:
02/20/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:49 PM
MET WITH:Tasha MathewsTIME VISIT/
INSPECTION COMPLETED:
03:17 PM
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On February 20, 2025, Licensing Program Analysts (LPAs) Stacey Williams and Elvira Sierra met with Facility Representative, Tasha Mathews for the purpose of a case management inspection. Licensee is requesting an increase of capacity to accommodate 63 children occupying two classrooms. Facility currently operates in classrooms D101 and E101 inside the Tracy Unified South West Park Elementary School. The facility's hours of operation are Monday through Friday from 8:30 a.m. to 11:30 a.m. and 12:30 p.m. to 3:30 p.m. The granted fire clearance was received on 2/11/2025 by Tracy-South County Fire Authority Community Risk Reduction. There were twenty seven children present during today's inspection.

LPA’s conducted a health and safety inspection in all areas accessible to children for classrooms D101 and E101. Measurements for classroom D101 are as follows: The total classroom space for classroom D101 contains a total of 1,092.9 square feet, which will accommodate a capacity of 31 preschool children. There are two toilets and two sinks available to children, and a separate staff restroom is available outside of the classroom.

Classroom E101 was previously inspected and measured by Application Specialist, (AS) Sifuentes on 9/20/2021. Per Facility Representative, Tasha Mathews there have not been any changes made to the classroom. The total classroom space contains a total of 1,234.863 square feet, which will accommodate the current capacity of 32 preschool children. There are three toilets and three sinks available to children, and a separate staff restroom is available. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

LPAs observed a functional carbon monoxide detector in both classrooms. LPAs observed disinfectants are inaccessible and appropriately stored.

A Shared Bathroom and Playground Waiver is on file. Individual measurements are recorded on the Capacity Worksheets (LIC 9024).
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: TRACY UNIFIED SCHOOL DISTRICT SOUTH/WEST PARK ELEM
FACILITY NUMBER: 393605949
VISIT DATE: 02/20/2025
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This facility provides Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

This facility evaluation report was reviewed and discussed with the Facility Representative. Facility Representative was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining to childcare centers.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Effective 2/20/2025 the facility is approved for a total capacity of 63 children. Capacity will include a maximum of 32 children classroom E101 and 31 children in classroom D101.

Exit interview conducted and report was reviewed with the Facility Representative, Tasha Mathews. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights were provided.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC809 (FAS) - (06/04)
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