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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507001405
Report Date: 02/23/2022
Date Signed: 03/29/2022 09:22:03 AM

Document Has Been Signed on 03/29/2022 09:22 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.270
SACRAMENTO, CA 95833
FACILITY NAME:CENTRAL VALLEY TRAINING CENTER, INC.FACILITY NUMBER:
507001405
ADMINISTRATOR:MARY VELAZQUEZFACILITY TYPE:
775
ADDRESS:1405 KANSAS AVENUE, SUITE CTELEPHONE:
(209) 522-0332
CITY:MODESTOSTATE: CAZIP CODE:
95351
CAPACITY: 126CENSUS: 22DATE:
02/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Mary VelazquezTIME COMPLETED:
03:30 PM
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Unannounced annual visit made out to this day program by LPA Charlie Yang on 02/23/2022 and was met by the Program Director, Mary Velazquez, who was briefly interviewed.
This day program is licensed to serve and retain up to 126 participants at any given time. This day program is also vendorized through Valley Mountain Regional Center with an established ration of 1:3 for staff to clients.
Tour of this day program was conducted. Portable hand washing stations and hand sanitizer dispensers were observed to be present and in good functional order at this time.
This facility is set up with a main hall area which can be divided and partitioned as needed for different events and settings. Fire extinguishers, located throughout this day program, were observed to have been annually inspected on 12/02/2021 and in compliance at this time.
A tour of the facility classrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the clients at this time.
A tour of the facility restrooms was conducted. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees.
Storage closet used for disinfectants, cleaning supplies, and all other items intended for client use was observed to be locked and made inaccessible at this time.
Laundry area was observed to be locked and made inaccessible to the clients at this time. It was learned that these machines were mainly used to clean and disinfect mops and other items used to clean and sanitize this day program.
Additional classrooms and office space, located in Suite D, were toured and observed to be able to meet the needs of the clients at this time.
Kitchen area was toured. Exterior grounds of this day program was conducted.
The following forms and documents were requested to be updated and submitted into CCL:

LIC 308, LIC 400, LIC 500, LIC 610
There were no deficiencies observed or cited during today's annual inspection. Exit Interview
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2022
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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