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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412608
Report Date: 03/05/2021
Date Signed: 03/05/2021 04:29:08 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:KINDERCARE LEARNING CENTERFACILITY NUMBER:
013412608
ADMINISTRATOR:KATHARINE STAUFFERFACILITY TYPE:
850
ADDRESS:4655 LASSEN ROADTELEPHONE:
(925) 455-1560
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY:72CENSUS: 24DATE:
03/05/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Catherine BollingerTIME COMPLETED:
04:45 PM
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On March 5, 2021 License Program Analyst (LPA) L. Dacanay Breaux and L. Clayton and License Program Manger (LPM) C. Charles conducted an unannounced Case Management inspect for the Preschool Component at the above mentioned Child Care Center. LPA and LPM met with the acting Director Catherine Bollinger. LPA toured for the Health and Safety Inspection. Present at the time of the inspection was 4 pre-school teachers on site and 24 pre-school children.

8:45 AM LPA requested to see and review files for the pre-school teachers.

(S1), (S2), (S3), (S4), and (S5) personnel files were reviewed. The 5 Preschool Teacher's met the Educational requirements.

LPA L. Clayton and L. Dacanay Breaux completed the Evaluation of Teacher Qualification for each teacher.

LPA L. Dacanay Breaux completed the Evaluation of Director Qualification for the Preschool component for Melinda Buxton.

Exit interview conducted with the Acting Director Catherine Bollinger and Notice of Site Visit was given and posted for 30 days.


SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2021
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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