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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393610932
Report Date: 01/10/2024
Date Signed: 01/10/2024 12:30:20 PM

Document Has Been Signed on 01/10/2024 12:30 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:CAPC - CENTRAL 1FACILITY NUMBER:
393610932
ADMINISTRATOR:SYHACHACK, MOMEFACILITY TYPE:
850
ADDRESS:540 NORTH CALIFORNIA STREETTELEPHONE:
(209) 644-5323
CITY:STOCKTONSTATE: CAZIP CODE:
95202
CAPACITY: 24TOTAL ENROLLED CHILDREN: 21CENSUS: 18DATE:
01/10/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kim BallardTIME COMPLETED:
11:00 AM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Director of Early Education, Kim Ballard for the purpose of a case management inspection. Licensee requests a change of capacity to serve 64 preschool children. The fire clearance (STD850) was granted and received on 1/5/2024. The program currently operates Monday through Friday from 7:30 a.m. to 5:30 p.m.

INDOOR ACTIVITY SPACE:
There are three preschool classrooms located on the first floor in Rooms 136, 139, and 143. LPA observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. LPA measured the preschool activity space. The preschool classroom contains a total of 2,516 square feet, which will accommodate Licensee’s request for 64 preschool children. There is two toilets and three sinks in Room 136, two sinks and one toilet in Room 139, three sinks and one toilet in Room 143, and one toilet and one sink in the preschool hallway bathroom giving a total of 5 toilets and 9 sinks for the children. There is a separate restroom for staff located towards the front entrance, down the hall, lobby area, and one upstairs.

OUTDOOR ACTIVITY SPACE:
There is one outdoor activity space. LPA observed a Shared Outdoor Space Waiver on file from 2017, however the waiver did not include toddlers. LPA will provide Licensee with an updated waiver to post. Director stated that there has been no changes of the outdoor activity space since licensure. LPA used current outdoor measurements from report dated 3/29/2021, therefore LPA did not take measurements. The outdoor activity space contains a total of 10,987 square feet, which will accommodate Licensee’s request for 64 preschool children.

Report continues on LIC809-C.
Mai Lor
Alecia Sifuentes
DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2024
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 2
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: CAPC - CENTRAL 1
FACILITY NUMBER: 393610932
VISIT DATE: 01/10/2024
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Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director of Early Education, Kim Ballard.

Effective today, 1/10/2024, LPA will approve the change of capacity for 64 preschool children.
SUPERVISOR'S NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024
LIC809 (FAS) - (06/04)
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