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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343603023
Report Date: 08/30/2019
Date Signed: 08/30/2019 08:47:13 AM

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:KINDERCARE LEARNING CENTER - VINTAGE PARK (SA)FACILITY NUMBER:
343603023
ADMINISTRATOR:ROMERO, TIAFACILITY TYPE:
840
ADDRESS:8887 VINTAGE PARK DR.TELEPHONE:
(916) 682-1111
CITY:SACTO.STATE: CAZIP CODE:
95828
CAPACITY:42CENSUS: 9DATE:
08/30/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
06:30 AM
MET WITH:Tia RomeroTIME COMPLETED:
09:00 AM
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Licensing Program Analyst (LPA) Christopher Bello met with Director, Tia Romero, regarding an Unusual Incident that took place on Sunday August 25th, 2019. LPA interviewed the director regarding the incident.

Director stated that the incident did not take place at the facility and did not affect any of the children.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the director and provided copies. An exist interview was conducted. LPA observed the Notice of Site Visit posted and the director understands it must remain posted for 30 days.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2019
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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