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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422041
Report Date: 10/05/2021
Date Signed: 10/05/2021 03:39:11 PM

Document Has Been Signed on 10/05/2021 03:39 PM - It Cannot Be Edited

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:ST. FELICITAS CATHOLIC PRESCHOOLFACILITY NUMBER:
013422041
ADMINISTRATOR:AGUIRRE, ALEDRAFACILITY TYPE:
850
ADDRESS:1650 MANOR BLVDTELEPHONE:
(510) 357-2530
CITY:SAN LEANDROSTATE: CAZIP CODE:
94579
CAPACITY: 20TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
10/05/2021
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
02:52 PM
MET WITH:Aledra AguirreTIME COMPLETED:
03:45 PM
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On 10/5/2021 at 2:52pm, LPA Plumboy met with Director Aledra Aguirre to conduct an unannounced Collateral visit for the purpose of interviewing a child. The child previously attended another facility.

An exit interview was conducted with Director. Appeal rights provided and discussed. A notice of site visit was posted and must remain posted for a period of 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2021
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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