394500233-8-26-2021-53-CC-CJAN-C69RWM-20210826132323

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500233
Report Date: 08/26/2021
Date Signed: 08/26/2021 01:23:27 PM

Document Has Been Signed on 08/26/2021 01:23 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	CAPC - NEIL HAFLEY		FACILITY NUMBER:	394500233
ADMINISTRATOR:	SANDEZ, RENEE		FACILITY TYPE:	850
ADDRESS:	849 NORTHGATE DRIVE		TELEPHONE:	(209) 851-3479
CITY:	MANTECA	STATE: CA	ZIP CODE:	95336
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 0	CENSUS: 9	DATE:	08/26/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Victoria Habiger		TIME COMPLETED:	01:30 PM

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Licensing Program Analyst (LPA) Christopher Jackson met with facility representative Victoria Habiger for the purpose of an unannounced random annual inspection on 8/26/21. There were nine pre-school children and 2 staff present upon arrival. All staff have been finger printed and cleared through Community Care Licensing and are associated to the facility. The facility operates in a classroom #1 on the campus of Neil Hafley Elementary. The program operates two part day programs. The AM program operates from 8:15 - 11:15 and the PM hours are 12:35 - 3:35 PM.

LPA toured the facility inside and out for a health and safety inspection. The facility is organized into defined areas for children to engage in activities. LPA observed the toys do not have any broken pieces or sharp edges. All cleaning supplies and hazardous items are stored in secured cabinets making them inaccessible to children in care. Restroom are sanitary and in operating condition. Trash containers for solid waste have lids. Drinking water was readily available inside and outside. Staff stated that portable jugs of water are used for the children. The playground equipment and outdoor activity space is maintained and in good condition. Wooden chips are being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. LPA discussed the requirement to conduct fire drills at least once every six months. Carbon Monoxide, fire extinguisher and smoke detectors were present and meet regulation.

The program provides snack only. Menu was posted in the classroom. The teacher stated, food is brought in into the facility from an outside vendor. Food preparation area is clean, food is protected from contamination, and all food or beverages are stored in covered containers and labeled.

Report Continues on 809-C

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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 - NEIL HAFLEY	FACILITY NUMBER: 394500233
	VISIT DATE: 08/26/2021

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Visual supervision for indoor activities was observed during today's inspection. Capacity and ratio requirements are being met. LPA reviewed four children’s files during today's inspection and observed the included information pertaining to their Emergency information, immunization records, Parents Rights and Personal Rights. LPA reviewed two Staff records during today's inspection. LPA observed the files included information regarding current CPR/First Aid for at least one staff member on site. Which expires on 07/2023. In addition LPA observed immunization records and documentation of the educational background, training, and/or experience. Staff stated they are waiting on the updated mandated training certificates to be placed in the files.

This facility currently does not provide Incidental Medical Services- IMS. LPA discussed storage of medication and equipment/supplies. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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. LPA observed no expired medication at time of inspection and proper authorization forms.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the facility representative can obtain updated licensing information, new regulations and access forms. LPA advised facility representative of their responsibility to stay current in regards to new regulations.

No Title 22 deficiencies were observed in the areas that were evaluated today. A Notice of Site Visit was posted and must remain posted for a period of 30 days. An exit interview was conducted with facility representative Victoria Habiger.

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC809 (FAS) - (06/04)

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