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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500300344
Report Date: 11/28/2022
Date Signed: 12/01/2022 12:01:20 PM

Document Has Been Signed on 12/01/2022 12:01 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.270
SACRAMENTO, CA 95833
FACILITY NAME:HOWARD PREPFACILITY NUMBER:
500300344
ADMINISTRATOR:CARLA STRONGFACILITY TYPE:
775
ADDRESS:1424 STONUM ROADTELEPHONE:
(209) 538-4000
CITY:MODESTOSTATE: CAZIP CODE:
95351
CAPACITY: 320CENSUS: DATE:
11/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jesus MunozTIME COMPLETED:
12:30 PM
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Unannounced annual visit made out to this day program on 11/28/2022 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated personnel, Jesus Munoz, who was briefly interviewed at this time.
It was learned that this day program was set up into (3) separate programs that ran independently of one another but were all housed at this location at this time.
Current census for total participants on site were 14 clients. This day program also utilized alternative forms of learning and interaction with their clients through Zoom and other media outlets.
Tour of the (2) buildings for this day program was conducted.
It was observed by this LPA that due to the low in-person census and social distancing requirements, there were only a total of (3) classrooms in use at this time. This was done so to maintain the mandates set forth through the Public Health Order.
A tour of the client classrooms was conducted. It was learned that this day program maintained a 1:3 ratio for staff to clients which was set forth through Valley Mountain Regional Center at this time. Staff ratios were observed to be maintained and in compliance at this time.
Fire extinguishers, located throughout the buildings, were observed to have been annually inspected by the local fire extinguisher company, Nor Cal Fire, on 04/12/2022 and in compliance at this time.
Storage units for cleanings agents, laundry, and bleach were observed to be locked and made inaccessible to the clients at this time.
Furniture and furnishings were observed to be sufficient and able to meet the needs of the clients at this time. A tour of the classroom restrooms was conducted. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees at all times.
This LPA did observe the presence of food storage units within the classrooms. It was learned that these units were mainly used to store the lunches that were brought to this day program by the clients. There wasn't any cooking or meal preps being conducted at this time for the clients.
A tour of the exterior facility grounds was conducted.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2022
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.270
SACRAMENTO, CA 95833
FACILITY NAME: HOWARD PREP
FACILITY NUMBER: 500300344
VISIT DATE: 11/28/2022
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Facility perimeter fence, side gates, and exits were reviewed at this time.

The following forms and documents were requested to be updated and submitted into CCL for review by this LPA:

LIC 308

LIC 400

LIC 500

LIC 610

There were no deficiencies observed or cited during today's annual visit.

Exit Interview
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
LIC809 (FAS) - (06/04)
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