394501396-10-30-2025-53-CC-ASIS-DMXPRM-20251030113257

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394501396
Report Date: 10/30/2025
Date Signed: 10/30/2025 11:33:17 AM

Document Has Been Signed on 10/30/2025 11:33 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	EL CONCILIO CA @ DON AVENUE		FACILITY NUMBER:	394501396
ADMINISTRATOR/ DIRECTOR:	GONZALEZ, VERONICA		FACILITY TYPE:	860
ADDRESS:	8121 DON AVE		TELEPHONE:	(209) 603-4118
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95209
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 36	CENSUS: 21	DATE:	10/30/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Linda Craig		TIME VISIT/ INSPECTION COMPLETED:	11:45 AM

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 and Licensing Program Analyst (LPA) Elvira Sierra met with Program Director/Licensee Representative (LR) Linda Craig for the purpose of a case management inspection. The facility is currently licensed for an infant and toddler components. LR requests to add a preschool component for 48 children ages two to five years old and increase the infant component capacity to 24 infants ages 12 to 24 months. LR is not making any changes to the toddler component and keeping the toddler capacity at 24 toddlers. The new total capacity requested is 96. The program currently operates Monday through Friday from 7:30 a.m. to 5:30 p.m. The fire clearance was granted and received on 10/14/2025. The facility will be providing breakfast, lunch, and snacks for all components. INDOOR ACTIVITY SPACE: There are two infant classrooms located in Infant Rooms #1 and #2, one toddler classroom located in Toddler Room #1/#2, and two preschool classrooms located in Preschool Rooms #1 and #2. LPA observed a sufficient amount of equipment, toys, tables, chairs, high chairs, cubbies, and napping cots. LPA used current measurements from report dated 3/24/2025, therefore LPA did not measure Infant Room #1. LPA measured Infant Room #2. The total infant classroom spaces contain a total of 1,286 square feet, which will accommodate LR's request for 24 infants. LPA observed one diaper changing table that is not within arms reach of a sink in Infant Room #2. LR stated that they will install a portable sink next to the diaper changing table. Report continues on LIC809-C page 2.

NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Alecia Sifuentes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025

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

California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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: EL CONCILIO CA @ DON AVENUE	FACILITY NUMBER: 394501396
	VISIT DATE: 10/30/2025

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
26
27
28
29
30
31
32

Page 2.

LPA informed LR that due to the facility having no crib space for the infants, LR will need to request a Sleeping Area for Infants Waiver.

LPA measured the Preschool Rooms #1 and #2. The total preschool classroom spaces contain a total of 2,066 square feet, which will accommodate LR’s request for 48 preschool children. There is one preschool bathroom located in Preschool Room #1. LPA observed a total of three sinks and four toilets. There is a second toddler/preschool bathroom located between Preschool Room #2 and Toddler Room 1#/#2. LPA observed a total of for sinks and four toilets. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

OUTDOOR ACTIVITY SPACE:
There are three outdoor areas on the property, Infant Yard, Toddler Yard, and Preschool Yard. The outdoor play areas are fenced with a cement wall and chain link fence that is at least four feet tall and separates the infant yard from the toddler yard and toddler yard from the preschool yard. LPA observed a play structure located on the preschool yard. LPA did not observed an age range listed on the play structure. LR provided LPA with a copy of the manufactures website showing that the play structure is approved for ages 2-5 years. LPA 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 a large canopy.

LPA used current measurements from report dates 3/24/2025, therefore LPA did not measure the Infant Yard. The total infant outdoor activity space contains a total of 1,936 square feet, which will accommodate LR's request for 24 infants. LPA measured the preschool outdoor activity space. The preschool outdoor activity space contains a total of 6,393 square feet, which will accommodate LR’s request for 48 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Report continues on LIC809-C page 3.

NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Alecia Sifuentes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025

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: EL CONCILIO CA @ DON AVENUE	FACILITY NUMBER: 394501396
	VISIT DATE: 10/30/2025

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
26
27
28
29
30
31
32

Page 3.

Licensee was reminded that all adults 18 and over, 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the LR Linda Craig.

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

1. Pending waiver review for Sleeping Area for Infants.

2. Photo of portable sink next to diaper changing table in Infant Room #2.

NAME OF LICENSING PROGRAM MANAGER: Belinda Devall
NAME OF LICENSING PROGRAM ANALYST: Alecia Sifuentes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025

LIC809 (FAS) - (06/04)

Page: 4 of 4