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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620822
Report Date: 03/02/2023
Date Signed: 03/02/2023 11:49:47 AM

Document Has Been Signed on 03/02/2023 11:49 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:CAPC - MANTECA DAYFACILITY NUMBER:
393620822
ADMINISTRATOR:JADE MEIHLFACILITY TYPE:
850
ADDRESS:737 WEST YOSEMITE AVENUETELEPHONE:
(209) 644-5311
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY: 32TOTAL ENROLLED CHILDREN: 15CENSUS: 12DATE:
03/02/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Victoria BrownTIME COMPLETED:
12:00 PM
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On 02/2723 Licensing Program Analyst (LPA) Elvira Sierra met with Site Supervisor, Victoria Brown for an unannounced Case Management Inspection. LPA observed 12 children being care by 2 staff members.

The purpose of today’s inspection was to follow up regarding a water sampling that indicated an Action Level Exceedance (ALE) for a drinking fountain (sink C) in classroom # 7 that was tested for lead levels on 05/11/22. Per Site Supervisor classroom # 7 has not been utilized and faucet that had an exceedance has been replaced and re-test on 12/13/22 showing no exceedances. Per facility, Room # 7 is not currently utilized for childcare. LPA advised Site Supervisor to informed the Department once they decided to open the classroom.

An Exit interview conducted, and the report was reviewed and provided to Site Supervisor, Victoria Brown. LPA posted the Notice of Site Visit and Site supervisor acknowledges it must remain posted for 30 days. A Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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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