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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010205790
Report Date: 08/31/2022
Date Signed: 08/31/2022 10:09:11 AM


Document Has Been Signed on 08/31/2022 10:09 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:ST. LEANDER PRE-KINDERGARTENFACILITY NUMBER:
010205790
ADMINISTRATOR:MARTINEZ, REBECCAFACILITY TYPE:
850
ADDRESS:451 DAVIS STREETTELEPHONE:
(510) 351-4144
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY:48CENSUS: 14DATE:
08/31/2022
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Rebecca MartinezTIME COMPLETED:
10:15 AM
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On Wednesday 8/31/2022 at approximately 9:15 AM Licensing Program Analyst Sabina Dodoo met with Director Rebecca Martinez. LPA interviewed a child at the facility for a complaint related to different facility.

A copy of this report was given to Director Rebecca Martinez.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2022
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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