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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574501189
Report Date: 08/15/2024
Date Signed: 08/15/2024 01:00:42 PM

Document Has Been Signed on 08/15/2024 01:00 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:YCOE - DR. JESSE ORTIZ CENTERFACILITY NUMBER:
574501189
ADMINISTRATOR/
DIRECTOR:		HERNANDEZ, SANDRAFACILITY TYPE:
860
ADDRESS:250 BUCKEYE STREETTELEPHONE:
(530) 668-3012
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 0DATE:
08/15/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Shannon McClarinTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Licensee Representative Shannon McClarin for the purpose of a pre-licensing change of location inspection. Licensee is requesting an infant component for 8 infants ages 0-24 months, a toddler component for 8 toddlers ages 18-36 months, and a preschool component for 32 children from age two years to entry into kindergarten for a total capacity of 48. The program will operate Monday through Friday from 7:30 a.m. to 4:30 p.m. The fire clearance was granted and received on 8/14/2024. The facility currently provides breakfast, lunch, and afternoon snack. Facility will provide formula and baby food.

LPA informed Licensee that the facility will be converted to a single child care center license under one facility number 013423773, therefore LPA will be closing the current infant and preschool facility numbers 013417823/010206120.

LPA reviewed with Licensee the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA discussed the safe sleep regulations with the Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

INDOOR ACTIVITY SPACE:
There is one infant classroom area (#3A) and one toddler classroom area (#3B) located in Room #3. The room is separated using a wall partition so that the components do not commingle. LPA observed a crib space in the infant area. The crib space is divided from the indoor activity space using a four-foot-tall wall partition. LPA observed three cribs available.

Report continues on LIC809-C page 2.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2024
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 4
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: YCOE - DR. JESSE ORTIZ CENTER
FACILITY NUMBER: 574501189
VISIT DATE: 08/15/2024
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Page 2.

There are two preschool classrooms located in Rooms #1 and #2. LPA observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and napping cots. There is a first aid kit in each of the classrooms. Medications will be stored in the medicine locked cabinet in each classroom. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Licensee stated there are no poisons or firearms on the premises. LPA observed water fountains in the each classroom. LPA observed a functional dual smoke and carbon monoxide detector. LPA observed an electronic sign-in/sign-out system.

LPA measured the infant classroom area (Room #3A). The infant classroom contains a total of 281 square feet which will accommodate Licensee’s request for 8 infants. LPA measured the toddler classroom area (Room #3B). The toddler classroom space contains a total of 340 square feet which will accommodate Licensee’s request for 8 toddlers. LPA measured the preschool classrooms (Rooms #1 and #2). The preschool classroom spaces contain a total of 1,137 square feet which will accommodate Licensee’s request for 32 preschool children. There are two sinks and one toilet located in Room #3. LPA observed a diaper changing table within arm’s reach of the sink. There are three toilets and four sinks located in Rooms #1 and #2. There is a private restroom for staff located next to the preschool bathroom and in the Room #3. 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 are two outdoor areas on the property, Infant/Toddler Playground and Preschool Playground. The outdoor play areas are fenced with a chain link fence that is at least four feet tall and separates the infant/toddler playground from the preschool playground. The Infant/Toddler Playground is divided in half separating the infant component from the toddler component. The designated infant area is located towards the left side of the yard and the designated toddler area is located towards the right side of the yard. LPA observed a sufficient amount of equipment and toys. There is one play structure located in the preschool playground. LPA observed a safety label on the play structure designated for ages 2 to 5 years old. There are no bodies of water on the premises. There are shaded areas supplied by canopies and overhang.

Report continues on LIC809-C page 3.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: YCOE - DR. JESSE ORTIZ CENTER
FACILITY NUMBER: 574501189
VISIT DATE: 08/15/2024
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Page 3.

LPA measured the Infant/Toddler Playground. The designated infant outdoor activity area contain a total of 903 square feet which will accommodate Licensee’s request for 8 infants. The designated toddler outdoor activity area contains of total of 903 square feet which will accommodate Licensee’s request for 8 toddlers. LPA measured the Preschool Playground. The preschool outdoor activity space contains a total of 3,141 square feet which will accommodate Licensee’s request for 32 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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) or (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

LPA 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. LPA discussed with Licensee 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.

Licensee was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Report continues on LIC809-C page 4.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: YCOE - DR. JESSE ORTIZ CENTER
FACILITY NUMBER: 574501189
VISIT DATE: 08/15/2024
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Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with Licensee Representative Shannon McClarin.

Effective today, 8/15/2024, LPA will approve the change of location for 8 infants 0-24 months, 8 toddlers 18-36 months, and 32 preschool children age two years to entry into kindergarten.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4