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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070211160
Report Date: 03/05/2024
Date Signed: 03/05/2024 04:20:05 PM

Document Has Been Signed on 03/05/2024 04:20 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:FIRST LUTHERAN CHRISTIAN PRESCHOOLFACILITY NUMBER:
070211160
ADMINISTRATOR:SMITH, JENIFACILITY TYPE:
850
ADDRESS:4006 CONCORD BOULEVARDTELEPHONE:
(925) 798-5330
CITY:CONCORDSTATE: CAZIP CODE:
94519
CAPACITY: 60TOTAL ENROLLED CHILDREN: 57CENSUS: 39DATE:
03/05/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:JENI SMITHTIME COMPLETED:
04:30 PM
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On 03/05/24 at 3:30 PM Licensing Program Analyst (LPA) Sikia Blue conducted an unannounced Case Management Plan of Correction inspection at FIRST LUTHERAN CHRISTIAN PRESCHOOL and met with Director, Jeni Smith. Present in the facility were 3 infants and 36 preschoolers with a total of 39 children in care. LPA explained the purpose of today's inspection is to verify corrections made as a result of citation issued on 12/19/23 for lead exceedance. Director has submitted a written plan of fixing the faucets. New fixtures for the faucets have been installed at the outlets which showed exceedance. Water testing has been conducted again and passed on 01/17/2024. Director did inform Licensing office when results were received and submitted proof of re-testing and results. Citations will be cleared as of today 03/05/2024.

This report was reviewed with Director, Jeni Smith.

NOTICE OF SITE VISIT WAS ISSUED, MUST BE POSTED FOR 30 DAYS.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2024
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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