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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412610
Report Date: 11/18/2021
Date Signed: 11/18/2021 01:12:56 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:
013412610
ADMINISTRATOR:CATHERINE BOLLINGERFACILITY TYPE:
830
ADDRESS:4655 LASSEN ROADTELEPHONE:
(925) 455-1560
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY:36CENSUS: 4DATE:
11/18/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Claudia ArguetaTIME COMPLETED:
01:15 PM
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Licensing Program Analysts (LPAs) Simejit Kaur and Julia Placencia arrived at facility to follow up with unusual incident occurred on November 10, 2021. LPAs toured the infant room, conducted interviews with staff and record review. The Acting Director Claudia Argueta, parents of the child and infant room staff has implemented a plan to prevent further incidents.

No deficiencies cited today.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Claudia Argueta.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Simerjit KaurTELEPHONE: (510) 622-2632
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
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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