Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620823
Report Date: 07/20/2017
Date Signed 07/20/2017 02:02:45 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:CAPC - GOLDEN WESTFACILITY NUMBER:
393620823
ADMINISTRATOR:SILVA, REBECCAFACILITY TYPE:
850
ADDRESS:1031 NORTH MAIN STREETTELEPHONE:
(209) 644-5311
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY:24CENSUS: 0DATE:
07/20/2017
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Laprice BrownTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Bettina Engelman and Licensing Program Manager (LPM) Sharon Ogbodo met with Laprice Brown, Early Education Director, Jade Meihl, Program Manager for a Case Management. Also present was Nancy Leal, Manteca Unified School District, Director of School Readiness. No children were present, as the program is on summer break.

LPA and LPM met with licensee representatives to inspect the playground area, which is in front of the preschool building. On a previous inspection. LPA had measured the playground to be 1,805 square feet, sufficient for the licensed capacity of 24.

Facility has exclusive use of a bathroom, which houses one toilet and a sink and is located in the building to the south of the preschool classroom. In addition, the facility has access to a second bathroom, which houses a toilet and a sink, and is located in the building to the north of the preschool building. Facility will share use of that second bathroom with the TK program, and a waiver has been requested and approved. LPA reminded facility staff of their responsibility to provide supervision and maintain mandated adult:child ratios as they escort children to the bathroom.

The playground area is surrounded by a fence, which is 3 feet and 6 inches tall. An 8-foot perimeter fence surrounds the entire Golden West Elementary School campus. A waiver has been requested and submitted for the fence height being less than the required 4 feet. An umbrella will be used to provide shade, and be brought out whenever children are present.

As of today's inspection, LPA and LPM approve the use of the playground. An exit interview was conducted and a Notice of Site Visit was posted.
SUPERVISOR'S NAME: Jennifer BrekkeTELEPHONE: (916) 263-5717
LICENSING EVALUATOR NAME: Bettina EngelmanTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2017
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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