393620957-1-5-2022-53-CC-CJAN-CADVGA-20220105152514

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393620957
Report Date: 01/05/2022
Date Signed: 01/05/2022 03:25:22 PM

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 - MCFALL		FACILITY NUMBER:	393620957
ADMINISTRATOR:	GOMEZ, MAYRA		FACILITY TYPE:	850
ADDRESS:	1810 HOYT LANE		TELEPHONE:	(209) 559-2131
CITY:	MANTECA	STATE: CA	ZIP CODE:	95336
CAPACITY:	40	CENSUS: 9	DATE:	01/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Tina Sigura		TIME COMPLETED:	03:30 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 01/05/22 Licensing Program Analyst (LPA) Christopher Jackson and CCL staff Karen Chang conducted an unannounced random annual inspection. LPA met with facility representative Blanca Noriega. A tour of the facility was conducted inside and outside. The following areas are in compliance during today's inspection. There are no bodies of water on site. Firearms and ammunition are not on the premises. Storage for cleaners are made inaccessible to children in care. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. LPA observed fire drills are documented and conducted at least once every 6 months. Carbon Monoxide detector was installed and functioning. Playground equipment and outdoor activity space is maintained and in good condition. Matting and shredded tire chips are being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. Food preparation area is clean, and all food or beverages are stored in covered containers and labeled to protect from contamination. Food is provided by an outside vendor and delivered to the facility daily. Trash containers for solid waste are covered. Drinking water is available both indoors and outside. Menus are posted. The facility is in compliance with conditions and limitations specified on the license. Sign in/sign out sheets are done on an ipad and maintained. No excluded individuals are present. Staff subject to a criminal record clearance or exemption are associated to the facility. First Aid/CPR reviewed and are in compliance. LPA observed First Aid and CPR to expire on 05/23. A review of nine children's records were conducted during today's inspection. All staff on site records were reviewed during today's inspection. Report Continues on 809-C

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2022

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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: CAPC - MCFALL	FACILITY NUMBER: 393620957
	VISIT DATE: 01/05/2022

NARRATIVE

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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 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

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Exit interview was conducted and report was reviewed with the facility representative Blanca Noriega. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2022

LIC809 (FAS) - (06/04)

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