394500440-8-30-2021-53-CC-ASIS-C6DP39-20210830105711

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500440
Report Date: 08/30/2021
Date Signed: 08/30/2021 10:57:21 AM

Document Has Been Signed on 08/30/2021 10:57 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:	PARVINS HOPELAND PRESCHOOL		FACILITY NUMBER:	394500440
ADMINISTRATOR:	UNNAMALAI ALGAPPAN		FACILITY TYPE:	850
ADDRESS:	5965 N PERSHING AVE		TELEPHONE:	(510) 386-5529
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY: 35	TOTAL ENROLLED CHILDREN: 0	CENSUS: 21	DATE:	08/30/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Ganesh Lakshmanan		TIME COMPLETED:	12:00 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	Application Specialist (AS) Alecia Sifuentes met with Applicant, Ganesh Lakshmanan for the purpose of an announced pre-licensing inspection. Applicant requests a preschool license to serve 35 preschool children from age two to entry into kindergarten. The program will operate Monday through Friday from 7:00 a.m. to 6:00 p.m. The fire clearance was granted on 8/11/2021. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat poster, menus, and daily schedule. AS discussed the forms that must be in each child's and each staff member's file. AS provided and discussed LIC311A, Effects of Lead Exposure brochure, Healthy Schools Act survey, and new immunization card. The facility will provide morning snack, lunch, and afternoon snack. INDOOR ACTIVITY SPACE: There are three preschool classrooms. AS observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. There is a first aid kit in the kitchen and school-age classroom. Medications will be stored in the kitchen. AS observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. AS observed a water pitchers and cups in each of the classrooms. AS observed a functional carbon monoxide detector in the hallway. AS observed sign-in/sign-out binder. Report continues on 809-C.

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021

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: PARVINS HOPELAND PRESCHOOL	FACILITY NUMBER: 394500440
	VISIT DATE: 08/30/2021

NARRATIVE

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AS measured three classrooms. The total classroom space contains a total of 1,227 square feet, which will accommodate Applicant's request for 35 preschool children. There are 3 toilets and 3 sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas on the property. The outdoor play area is fenced with wooden fence that is at least four feet tall. Play yard 1 will be shared with the school-age children. Applicant has requested a Shared Playground Waiver. AS observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by trees and overhangs.

AS measured the outdoor activity space. The outdoor play area contains a total of 2,879 square feet, which will accommodate Applicant's request for 35 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Incidental Medical Services and a Plan of Operation is located in the facility file. 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.

Report continues on 809-C.

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021

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: PARVINS HOPELAND PRESCHOOL	FACILITY NUMBER: 394500440
	VISIT DATE: 08/30/2021

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AS discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

This facility evaluation report was reviewed and discussed with Applicant. Applicant was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

AS will issue a provisional license that will expire in 90 days on 11/28/2021. Once the provisional is issued, the following items are to be submitted prior to expiration of the provisional license for final approval of license:

1. Remaining paperwork listed on LIC184.
2. Final approval from Licensing Program Manager (LPM) Bettina Engelman.

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021

LIC809 (FAS) - (06/04)

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