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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620622
Report Date: 06/17/2019
Date Signed: 06/17/2019 11:13:29 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:TRACY LEARNING CENTER PRE KINDERGARTENFACILITY NUMBER:
393620622
ADMINISTRATOR:CAMPBELL, HEATHERFACILITY TYPE:
850
ADDRESS:238 WEST GRANTLINE ROAD #BTELEPHONE:
(209) 229-1575
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY:74CENSUS: 31DATE:
06/17/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Heather CampbellTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Mary Ponce met with director Heather Campbell for a Case Management- Other inspection regarding a Confirmation Removal for an adult working for the program. During the inspection, LPA Ponce toured the facility and interviewed the director. LPA did not observe the excluded individual present at the facility and director stated that their role was to drop off food from the school to the preschool program. Director stated the individual will no longer drop food of at the program or work in the facility under any capacity until exemption is approved.


SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Mary PonceTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019
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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