Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393610932
Report Date: 09/09/2016
Date Signed: 09/09/2016 02:47:19 PM

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:CAPC-CENTRAL 1FACILITY NUMBER:
393610932
ADMINISTRATOR:KIM PAWLOWICZFACILITY TYPE:
850
ADDRESS:540 N. CALIFORNIA ST.TELEPHONE:
(209) 644-5323
CITY:STOCKTONSTATE: CAZIP CODE:
95202
CAPACITY:40CENSUS: 0DATE:
09/09/2016
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Kim BallardTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Emerita Curiel and Licensing Program Manager (LPM) Jennifer Brekke met with the Director Kim Ballard to conduct a case management visit for a capacity increase. Licensing staff toured the facility inside and out. Staff observed zero children in care. The facility has requested an increase of capacity to the license from 40 children to 56 preschooler’s age range 2 to kindergarten. Licensing staff has received the required fire clearance for the new capacity of 56 children and is on file with the Licensing Agency.

Indoor Activity Space

The indoor activity area included rooms 143, 136, and 148 measured a total of 2,075 square feet which is enough for the capacity requested. A total of 4 toilets and 7 sinks were available for children's use which will accommodate the requested capacity. The facility has two separate restrooms for staff only.

Outdoor Active Space

The outdoor activity area measured a total of 10,987 square feet which is enough for the capacity requested.

Effective today September 9, 2016, Licensing Staff is granting a capacity increase for up to 56 children including up to 4 school age children. There were no deficiencies cited during today's visit. Notice of Site Visit provided.

SUPERVISOR'S NAME: Jennifer BrekkeTELEPHONE: (916) 263-5717
LICENSING EVALUATOR NAME: Emerita CurielTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2016
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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