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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500401
Report Date: 07/29/2021
Date Signed: 07/29/2021 11:24:49 AM

Document Has Been Signed on 07/29/2021 11:24 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 250
SACRAMENTO, CA 95833
FACILITY NAME:DJUSD EARLY LEARNING CENTER AT KOREMATSUFACILITY NUMBER:
574500401
ADMINISTRATOR:JENNA GONZALEZFACILITY TYPE:
850
ADDRESS:3100 LOYOLA DRIVETELEPHONE:
(530) 757-5340
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/29/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jenna GonzalezTIME COMPLETED:
12:00 PM
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Application Specialist (AS) Alecia Sifuentes and Licensing Program Analyst (LPA) Chayntel Hunter met with Director, Jenna Gonzalez for the purpose of an announced pre-licensing inspection. Director requests a preschool license to serve 60 preschool children from age two to entry into first grade. The program will operate Monday through Friday from 7:30 a.m. to 4:00 p.m. The fire clearance was granted on 6/28/2021.

Director acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat poster, menus, and daily schedule. Documents will be posted in the office. The facility will provide morning snack, lunch, and afternoon snacks.

INDOOR ACTIVITY SPACE:
There are three preschool classrooms: Classroom 3, 4, and 5. AS observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. There is a first aid kit in each of the classrooms in the cabinet. Medications will be stored in the classrooms in the the cabinet. AS observed cleaning disinfectants are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Director stated children will bring their own water bottles and the facility has water refill stations. AS observed a functional dual smoke and carbon monoxide detector in each classroom. AS observed sign-in/sign-out binders.

Report continues on 809-C.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2021
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: DJUSD EARLY LEARNING CENTER AT KOREMATSU
FACILITY NUMBER: 574500401
VISIT DATE: 07/29/2021
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AS measured three classrooms. The total classroom space contains a total of 2,129 square feet, which will accommodate Director's request for 60 preschool children. There are six toilets and nine sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. The outdoor play area is fenced with a wrought iron fence that is at least four feet tall. Director has requested a Shared Playground Waiver due to the Special Ed. program utilizing the playground. AS observed a sufficient amount of equipment and toys. The play structure includes a safety label, which designates use for children 2 to 5 years old. There are no bodies of water on the premises. There are shaded areas supplied by overhangs and a canopy.

AS measured the outdoor activity space. The outdoor play area contains a total of 10,692 square feet, which will accommodate Director's request for 60 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

The facility's Incidental Medical Services Plan of Operation is located in the facility file. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department.

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.

Report continues on 809-C.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: DJUSD EARLY LEARNING CENTER AT KOREMATSU
FACILITY NUMBER: 574500401
VISIT DATE: 07/29/2021
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AS discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Director any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

This facility evaluation report was reviewed and discussed with Director. Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

Effective today, 7/29/2021, AS will approve the facility for a capacity of 60 children licensed to serve children two years to entry into first grade.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
LIC809 (FAS) - (06/04)
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