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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621067
Report Date: 05/16/2022
Date Signed: 05/16/2022 11:43:58 AM

Document Has Been Signed on 05/16/2022 11:43 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:CAP KERN EARLY HEAD START PROG - CHRISMANFACILITY NUMBER:
393621067
ADMINISTRATOR:PATRICIA MEXICANOFACILITY TYPE:
830
ADDRESS:23950 S CHRISMAN ROADTELEPHONE:
(209) 242-9540
CITY:TRACYSTATE: CAZIP CODE:
95304
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 10DATE:
05/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Patricia MexicanoTIME COMPLETED:
12:00 PM
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Licensing Program Analysts (LPA) Christopher Jackson met with Director, Patricia Mexicano for the purpose of an unannounced Annual inspection. There were ten children present during today's inspection. LPA toured the facility inside and out. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility days and hours of operation are Monday - Friday from 7:30 AM to 5:30 PM. The director said, no bottles are used at the facility as all infants in care are 12 months or older.

LPA reviewed care and supervision of children, staffing ratios, medications and first aid supplies, furniture, equipment, fire drills and drinking water. LPA observed all required forms to be posted. LPA observed a dual functioning carbon monoxide and smoke alarms. There were nap mats available for infants over 12 months old. There are needs and services plans for each infant and toddler enrolled. LPA observed a changing table within arm's reach of the sink. There are adequate toys and equipment available for children. Outdoor play area was toured, the play equipment for the infants and toddlers appeared to be in good repair. Grass is the t cushioning under the play equipment to prevent the fall. There is an infant outside play space, that is separated from the other play areas.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. In addition, LPA discussed the infant sleep regulations with director. LPA discussed the requirement to check and log infant napping every 15 minutes. LPA observed the 15 minute checks for infants during today's inspection, per safe sleep regulations.

Report continues on 809-C.
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2022
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: CAP KERN EARLY HEAD START PROG - CHRISMAN
FACILITY NUMBER: 393621067
VISIT DATE: 05/16/2022
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LPA reviewed the sign in/out book and observed that the children are properly signed in. LPA reviewed ten children’s and four staff files. All staff present during today's inspection have a fingerprint clearance. 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.

LPA observed health screening reports with TB test and required MMR and TDAP vaccines for all staff members. At least one staff member present today has current Pediatric CPR and First Aid which expire on 03/05/2024. LPA observed AB1207 mandated reporter training for all staff. The Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website.
LPA verified annual fees were current.

Incidental Medical Services (IMS) policy was discussed. Facility has a plan in place. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

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/inspection-process.

Exit interview conducted and report was reviewed with the Facility representative. 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 the inspection.
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
LIC809 (FAS) - (06/04)
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