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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444412437
Report Date: 07/03/2019
Date Signed: 07/03/2019 09:15:08 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:EARLY CHILDHOOD LEARNING CENTERFACILITY NUMBER:
444412437
ADMINISTRATOR:TERI ESPARZAFACILITY TYPE:
850
ADDRESS:570 BETHANY DRIVETELEPHONE:
(831) 438-7980
CITY:SCOTTS VALLEYSTATE: CAZIP CODE:
95066
CAPACITY:56CENSUS: 14DATE:
07/03/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Lisa PattersonTIME COMPLETED:
09:20 AM
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A visit was made by Analyst Behbood to conduct annual visit. Met Lisa Patterson, Preschool Administrative Director. Lisa informed analyst the facility was visited by Analyst Hakim on Friday June 28, 2019. Additional information about her other site were obtained.
No deficiency was issued.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
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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