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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620682
Report Date: 11/01/2024
Date Signed: 11/01/2024 12:27:40 PM

Document Has Been Signed on 11/01/2024 12:27 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:CAP KERN EARLY HEAD START PROGRAM - CALIFORNIA ST.FACILITY NUMBER:
393620682
ADMINISTRATOR/
DIRECTOR:		MOME SYHACHACKFACILITY TYPE:
830
ADDRESS:425 NORTH CALIFORNIA STREETTELEPHONE:
(209) 242-9540
CITY:STOCKTONSTATE: CAZIP CODE:
95202
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 19DATE:
11/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Judy Artellan and Nicole NinoTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 11/01/24, Licensing Program Analyst (LPA) Elvira Sierra met with Site Supervisor, Judy Artellan and Program Manager, Nicole Nino for the purpose of an unannounced annual inspection. Facility representative was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility operates M-F from 07:30 a.m to 05:15 p.m. Facility is a Early Head Start State and Federal funding program with infant/toddler component on site. Facility is open all year long except holidays. All staff present today have criminal record clearances on file. Present at the facility were 19 children and nine staff members.

LPA inspected the facility including all activity and classroom spaces, restrooms, food service, and outdoor play areas. Currently two children enrolled are on medications. Medication for the children are kept in a clear box in the upper cabinet in each classroom. Medications were reviewed and are stored according to regulations. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. LPA observed that storage containers for solid waste and diaper disposal have tight-fitting covers. LPA observed that the infant's bottles are labeled and stored appropriately. Program provides breakfast, lunch, and afternoon snacks for toddlers and infants who are on solids. Also program provides the formula for the infants. Food is deliver by Stockton Kitchen and staff warm up the food for the children. The food preparation area is free of litter and all food is protected against contamination. Menus are posted in the classroom and drinking water was readily available to children both indoors and outdoors via pitcher and cups for the toodlers and infants have their own sippy cup. Facility uses electronic signature capture using ChildPlus software. Facility has a tablet in every classrooms accessible to parents to sign in/out. LPA and Site Supervisor reviewed the electronic sign in/out attendance. LPA observed that the number of children sign in at the facility match the number of children present. Playground equipment and surfaces are free of loose or sharp parts. LPA observed the infant's Needs and Services Plans are current.


Report continues on subsequent page 809-C.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024
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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CAP KERN EARLY HEAD START PROGRAM - CALIFORNIA ST.
FACILITY NUMBER: 393620682
VISIT DATE: 11/01/2024
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Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm



Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
Testing Expiration Date: 10/25/27.
Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Site Supervisor, Judy Artellan.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024
LIC809 (FAS) - (06/04)
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