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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710224
Report Date: 10/10/2019
Date Signed: 10/10/2019 04:37:51 PM

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:BING NURSERY SCHOOLFACILITY NUMBER:
430710224
ADMINISTRATOR:WINTERS, JENNIFERFACILITY TYPE:
850
ADDRESS:850 ESCONDIDO ROADTELEPHONE:
(650) 723-4865
CITY:STANFORDSTATE: CAZIP CODE:
94305
CAPACITY:125CENSUS: 7DATE:
10/10/2019
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Jennifer WintersTIME COMPLETED:
04:45 PM
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On 10/10/19 Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Collateral visit regarding a child who attended another facility. LPA met with Director,interviewed staff and reviewed records.

No citation was issued today.
Notice of Site Visit was issued.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
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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