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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621636
Report Date: 03/28/2023
Date Signed: 03/28/2023 11:44:41 AM

Document Has Been Signed on 03/28/2023 11:44 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:FREMONT ELEMENTARY SCHOOLFACILITY NUMBER:
393621636
ADMINISTRATOR:MARTINEZ, JOSEPHFACILITY TYPE:
850
ADDRESS:2021 E. FLORATELEPHONE:
(209) 933-7385
CITY:STOCKTONSTATE: CAZIP CODE:
95205
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 13DATE:
03/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Alicia GilTIME COMPLETED:
12:00 PM
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On March 28th, 2023, at 9:30 am, Licensing Program Analysts (LPAs) Lauren Scott and David Nguyen met with facility representative, Teacher Alicia Gil, for the purpose of an unannounced Annual inspection. LPA toured the facility inside and out. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. Facility has an AM and PM program. Their hours of operation are Monday-Friday from 8:00AM to 11:00AM (AM program) and 12:00PM to 3:00PM (PM program). Facility provides breakfast to AM program and lunch to the PM program, which is supplied by the school district. There were thirteen (13) children present during today's inspection. Facility runs on a 10-month program from August-May.

LPA reviewed staffing ratios, first aid supplies, furniture, equipment, fire drills and drinking water. LPA observed all required forms to be posted. LPA observed functioning carbon monoxide and smoke alarms. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure appeared to be in good repair, and there is sufficient cushioning (artificial grass) under the play structure.

LPA reviewed the sign in/out book and observed that the children are properly signed in. LPA reviewed 5 children’s and 4 staff files. All staff present during today's inspection have a fingerprint clearance. Facility's fingerprint clearances are conducted through the school district. 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.

Report continues on 809-C.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: FREMONT ELEMENTARY SCHOOL
FACILITY NUMBER: 393621636
VISIT DATE: 03/28/2023
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LPA observed health screening reports with TB test and required MMR and TDAP vaccines. At least one staff member present today has current Pediatric CPR and First Aid. LPA observed AB1207 Mandated Reporter training certificates for all staff. The Teacher was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medications 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. 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: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
LIC809 (FAS) - (06/04)
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