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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393619989
Report Date: 04/26/2023
Date Signed: 04/26/2023 11:14:36 AM

Document Has Been Signed on 04/26/2023 11:14 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:HARVEST PRESCHOOL & CHILD CAREFACILITY NUMBER:
393619989
ADMINISTRATOR:JAMIE ROWLEYFACILITY TYPE:
850
ADDRESS:10088 NORTH HIGHWAY 99TELEPHONE:
(209) 751-4451
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 36DATE:
04/26/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Jamie RowleyTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Mariya Melnichuk met with Director, Jamie Rowley to follow up on an Unusual Incident Report (UIR) that was reported to Community Care Licensing on 4/12/2023. During today's visit the facility was toured. There were 36 children present.

LPA interviewed the staff who were present during the incident. LPA reviewed and discussed this report with Director, Jamie Rowley. LPA observed the yard and location where the incident occurred. Staff were supervising children in the play yard.

The facility reported the UIR to Community Care Licensing within 24 hours. Facility was reminded to submit the physical UIR within 7 days.

Facility evaluation report was reviewed and discussed with Director, Jamie Rowley. Exit interview was conducted. 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.

In the areas that were evaluated, no deficiencies were cited during today's inspection.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Mariya Melnichuk
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2023
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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