394501262-2-3-2025-53-CC-ASIS-DDJSW4-20250203131344

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394501262
Report Date: 02/03/2025
Date Signed: 02/03/2025 01:13:51 PM

Document Has Been Signed on 02/03/2025 01:13 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	MS PATS PLACE TO GROW LEARNING ACADEMY		FACILITY NUMBER:	394501262
ADMINISTRATOR/ DIRECTOR:	SHEREE JOHNSON		FACILITY TYPE:	860
ADDRESS:	2929 S. B. STREET		TELEPHONE:	(209) 487-2610
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95206
CAPACITY: 58	TOTAL ENROLLED CHILDREN: 58	CENSUS: 0	DATE:	02/03/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Patricia Evelyn		TIME VISIT/ INSPECTION COMPLETED:	12:30 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	Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Applicant Patricia Evelyn and Director Sheree Johnson for the purpose of a pre-licensing inspection. Applicant requests a preschool component for 12 preschool children ages two years to entry into kindergarten and a school-age component for 42 children ages kindergarten to fourteen years for a total capacity of 54. The program will operate Monday through Friday from 8:00 a.m. to 6:30 p.m. The facility will provide breakfast, lunch, and afternoon snacks. The facility will be providing afternoon snack during the school year and during holidays and summer for the school-age program. LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. INDOOR ACTIVITY SPACE: There is one preschool classroom located in Room #1 upstairs (2nd floor) and two school-age classrooms located in Room #2 upstairs (2nd floor) and school-age Multipurpose Room (MPR) located downstairs (1st floor). LPA observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. There is a first aid kit in each of the classrooms on top of the high cubbies. Medications will be stored in the school-age classroom cabinet. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. LPA observed water dispenser in each of the classrooms. LPA observed a functional carbon monoxide detector in the hallway. LPA observed a sign in/sign out binder. LPA measured the preschool classroom. The total classroom space contains a total of 1,115 square feet, which will accommodate applicant's request for 12 preschool children. LPA measured the school-age classrooms. The total classroom spaces contain a total of 1,621 square feet, which will accommodate applicant’s request for 42 school-age children. Report continues on LIC809-C page 2.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MS PATS PLACE TO GROW LEARNING ACADEMY	FACILITY NUMBER: 394501262
	VISIT DATE: 02/03/2025

NARRATIVE

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Page 2.

There is one preschool bathroom with five toilets and three sinks and one school-age bathroom with three toilets/one urinal and three sinks. Both bathrooms are located downstairs (first floor). There is a separate private restroom for the staff located upstairs (second floor) in the preschool classroom. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the MPR and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas on the property, Preschool Play Area and School-age Playground. The outdoor play areas are fenced with a chain link fence that is at least four feet tall and separates the preschool yard from the school-age yard. LPA observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. LPA did not observe a shade on the outdoor activity spaces. Applicant states that they have the portable canopies that will be used prior to installing a permanent shade structure.

LPA measured the preschool outdoor activity space. The outdoor play area contains a total of 1,385 square feet, which will accommodate applicant's request for 12 preschool children. LPA measured the school-age outdoor activity space. The outdoor area contains a total of 3,158 square feet, which will accommodate applicant’s request for 42 school-age children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (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 LIC809-C page 3.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MS PATS PLACE TO GROW LEARNING ACADEMY	FACILITY NUMBER: 394501262
	VISIT DATE: 02/03/2025

NARRATIVE

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LPA 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. LPA 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.

Applicant 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.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Written Directives for Lead Testing in Child Care Centers: Assembly Bill 2370, Chapter 676, Statutes of 2018, added Health and Safety Code section 1597.16 requiring all licensed Child Care Centers constructed before January 1, 2010, test their water for lead between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first lead testing. For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

Report continues on LIC809-C page 4.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MS PATS PLACE TO GROW LEARNING ACADEMY	FACILITY NUMBER: 394501262
	VISIT DATE: 02/03/2025

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant, Patricia Evelyn.

The following item is required before a license will be issued:

1. Amended STD850.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025

LIC809 (FAS) - (06/04)

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