Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393616652
Report Date: 01/13/2017
Date Signed 01/13/2017 02:36:05 PM

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:MANTECA PARKS & REC., KIDS ZONE - GEORGE MCPARLANDFACILITY NUMBER:
393616652
ADMINISTRATOR:LOMA, VICTORIAFACILITY TYPE:
840
ADDRESS:1601 NORTHGATE DRIVETELEPHONE:
(209) 456-8600
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY:30CENSUS: 19DATE:
01/13/2017
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Victoria LomaTIME COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Bettina Engelman met with Victoria Loma, Recreation Coordinator, for a Case Management visit. The licensee had recently submitted an application for an increase in capacity from 30 to 60 school-age children. The Department had received the fire clearance, and the facility is cleared for 60 children

LPA toured the facility inside and outside. The program operates in a portable building, P12, on the campus of George McParland Elementary School. Licensee is requesting to add the school’s cafeteria to the licensed room P12. The facility will continue using the playground near Room P12 as previously approved. LPA determined the cafeteria to be free of hazards and safe to use as additional space, should the enrollment numbers increase in the future.

As of today’s visit, the facility is licensed with a capacity of 60. An exit interview was conducted, and a Notice of Site Visit was posted.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Bettina EngelmanTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2017
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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