393620822-1-29-2025-53-CC-JDAS-DDDUPE-20250129144526

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393620822
Report Date: 01/29/2025
Date Signed: 01/29/2025 02:55:54 PM

Document Has Been Signed on 01/29/2025 02:55 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:	CAPC - MANTECA DAY		FACILITY NUMBER:	393620822
ADMINISTRATOR/ DIRECTOR:	VICTORIA BROWN		FACILITY TYPE:	850
ADDRESS:	737 WEST YOSEMITE AVENUE		TELEPHONE:	(209) 825-8304
CITY:	MANTECA	STATE: CA	ZIP CODE:	95336
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 32	CENSUS: 14	DATE:	01/29/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:10 PM
MET WITH:	Victoria Brown		TIME VISIT/ INSPECTION COMPLETED:	03:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 01/29/2025 at 12:10 PM, Licensing Program Analyst (LPA) Janie Davis met with Site Supervisor Victoria Brown for the purpose of an unannounced annual inspection. Entrance Checklist (LIC 125) was provided to Site Supervisor, and Site Supervisor guided LPA on a tour of the facility. LPA observed three staff supervising 14 children. Facility days and hours of operation are Monday through Friday from 8:00 AM to 11:00 AM and from 12:15 PM to 3:15 PM. LPA verified that annual fees are current. All individuals subject to a criminal record review have obtained a criminal record clearance. Site Supervisor 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 five 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. A health and safety inspection of the facility’s interior and exterior was conducted. LPA reviewed the sign-in/out sheets (electronic) and observed that children were properly signed in/out. LPA observed the required postings. LPA reviewed staffing ratios, first aid supplies, furniture, equipment, fire drills, and access to drinking water. LPA verified that hazardous items (disinfectants, cleaning solutions, etc.) were inaccessible to children in care. LPA observed dual smoke and carbon monoxide detectors were functional. LPA observed adequate age-appropriate toys and equipment available for children. Facility provides snack. The outdoor play area was inspected. LPA observed the play structure was in good repair and was sufficiently cushioned by woodchips. Continues on 809-C

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CAPC - MANTECA DAY	FACILITY NUMBER: 393620822
	VISIT DATE: 01/29/2025

NARRATIVE

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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 five 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.

LPA reviewed children’s files and verified each child’s file contained required documents, including emergency information. LPA reviewed staff’s files and discussed required documents, including health screening reports with TB clearance and required immunizations. LPA verified all staff have current Mandated Reporter Training certificates. LPA verified at least one staff member present has current EMSA pediatric CPR and first aid certification which expires on 04/2026.

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/.

To improve the quality and value of the new inspection process, a survey may be sent to the e-mail address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE Tool, please send e-mail 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. Site Supervisor was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Continued on 809C...

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

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: CAPC - MANTECA DAY	FACILITY NUMBER: 393620822
	VISIT DATE: 01/29/2025

NARRATIVE

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Exit interview conducted and report was reviewed with the facility representative, Victoria Brown. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements may result in an immediate civil penalty of $100.

LPA Davis informed the facility, that this report dated January 29, 2025, documents one Type B citation, stating there is a potential risk to the health, safety, or personal rights of children in care.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

LIC809 (FAS) - (06/04)

Page: 2 of 4

Document Has Been Signed on 01/29/2025 03:15 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 01/29/2025 03:09 PM

Created By: Janie Davis On 01/29/2025 at 02:26 PM

Link to Parent Document Below:

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: CAPC - MANTECA DAY	FACILITY NUMBER: 393620822
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101217(a)

Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 3 eployees which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/01/2025
	Plan of Correction
1 2 3 4	Facility will provide proof of documentation in accordance with LIC125 within 30 days via email or fax.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Chayntel Hunter

LICENSING EVALUATOR NAME:

Janie Davis

LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

LIC809 (FAS) - (06/04)

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