<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393611645
Report Date: 08/29/2024
Date Signed: 08/29/2024 11:19:25 AM

Document Has Been Signed on 08/29/2024 11:19 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:CAMP HUTCHINS OF LODI MEMORIAL HOSPITALFACILITY NUMBER:
393611645
ADMINISTRATOR/
DIRECTOR:		SANDRA ETHERTONFACILITY TYPE:
850
ADDRESS:125 SOUTH HUTCHINS STREETTELEPHONE:
(209) 334-2267
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY: 53TOTAL ENROLLED CHILDREN: 53CENSUS: 22DATE:
08/29/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Teresa Whitmire and Sandra JohnsonTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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
Licensing Program Analyst (LPA) Erwin Tjhia, met with the administrator, Teresa Whitmire, and Site Supervisor, Sandra Johnson for a Case Management Inspection.

During LPA visit on 07/09/2024, LPA observed 35 school age children at the facility supervised by one teacher. LPA was informed by the center director, Carla Barba, and Site Supervisor, Sandra Johnson that the School Age classroom was in Summer Program. The Director also stated that the summer camp was 2 months (8 weeks) long and it was from 7 am to 6 pm, Monday to Friday. Facility was unable to provide proof that the summer camp was an exemption program and was not under licensing regulation.

Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files.

This report was reviewed and discussed with administrator, Teresa Whitmire,. A notice of site visit and appeal rights were provided

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2024
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
Document Has Been Signed on 08/29/2024 11:19 AM - It Cannot Be Edited


Created By: Erwin Tjhia On 08/29/2024 at 07:01 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CAMP HUTCHINS OF LODI MEMORIAL HOSPITAL
FACILITY NUMBER: 393611645

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
08/30/2024
Section Cited
CCR
101161(a)

1
2
3
4
5
6
7
A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement was not met as evidenced by :
1
2
3
4
5
6
7
LPA will conduct follow up visit to verify compliance.
8
9
10
11
12
13
14
During the visit on 07/09/2024, LPA observed 35 school age children at the facility which poses an immediate health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karyn Guerra
LICENSING EVALUATOR NAME:Erwin Tjhia
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2