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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500015
Report Date: 02/26/2025
Date Signed: 02/26/2025 02:58:16 PM

Document Has Been Signed on 02/26/2025 02:58 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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CAPC - NORTH (PRESCHOOL)FACILITY NUMBER:
394500015
ADMINISTRATOR/
DIRECTOR:
MARISOL GARCIAFACILITY TYPE:
850
ADDRESS:2875 HOLLY DRIVETELEPHONE:
(209) 278-3470
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY: 24TOTAL ENROLLED CHILDREN: 17CENSUS: 13DATE:
02/26/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Naomi Johnoson TIME VISIT/
INSPECTION COMPLETED:
03:23 PM
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On February 26, 2025, Licensing Program Analyst (LPA) Stacey Williams met with Facility Representative, Naomi Johnson for the purpose of an unannounced random inspection. The facility operates Monday- Friday from 8:30 AM-3:00PM next to North Elementary School in portable #2. Upon arrival, LPA observed thirteen (13) children supervised by three staff. Criminal record clearances were verified. There are two waivers on file( fingerprinting and shared outdoor space).

LPA conducted a health and safety inspection for all areas accessible to children. Representative stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. LPA observed a functional smoke/carbon monoxide detector and a fully charged 3A :40BC fire extinguisher. The floors appeared clean throughout the facility. Outdoor play area is free from dangerous conditions and playground equipment is securely anchored to the ground. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to absorb a fall. Shade is provided to children via trees and awning. Drinking water was readily available to children both indoors and outdoors. Program provides breakfast, lunch and afternoon snack. Sign in/out is done electronically through ChildPlus App.

Child files were reviewed. Each child’s file included information pertaining to their authorized representative, consent for medical treatment, immunization records, and a medical assessment form. Files for staff who were present at the facility were reviewed. Files contained required documents. Mandated Reporter Training was discussed and is current. Mandated Reporter training must be completed once every two years, and training is accessible at www.mandatedreporterca.com.

Health screening report, immunization records, and documentation of their educational background, training, and/or experience was verified in files. CPR/ First Aid certification was verified for staff present. Site Supervisor has a CPR/First Aid certification with an expiration date of 3/2025. Fire drills are conducted at least every six months. The last drill was done 2/2025.

LPA reviewed the Department's inspection authority and discussed with staff any changes that may occur regarding Director/Site Supervisor or an employee acting in the director's absence must be reported to department within 10 working days.

Continued on LIC 809-C.....

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CAPC - NORTH (PRESCHOOL)
FACILITY NUMBER: 394500015
VISIT DATE: 02/26/2025
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Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 5-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.

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 5-years after the date of the first test. For childcare 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.

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/.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email 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.

No citations were issued based on today’s inspection. Exit interview conducted and report was reviewed with the Facility Representative, Naomi Johnson. 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. Appeal Rights were provided.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025
LIC809 (FAS) - (06/04)
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