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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408231
Report Date: 05/22/2023
Date Signed: 05/22/2023 03:30:13 PM

Document Has Been Signed on 05/22/2023 03:30 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:SRVUSD EARLY CHILDHOOD EDUCATION PP - LIVE OAKFACILITY NUMBER:
073408231
ADMINISTRATOR:ROSENZWEIG, NADINEFACILITY TYPE:
850
ADDRESS:5151 SHERWOOD WAYTELEPHONE:
(925) 803-3100
CITY:SAN RAMONSTATE: CAZIP CODE:
94582
CAPACITY: 24TOTAL ENROLLED CHILDREN: 16CENSUS: 16DATE:
05/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:36 PM
MET WITH:Nada HuseniTIME COMPLETED:
03:14 PM
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On 5/22/2023 at 1:36pm Licensing Program Analyst (LPA) Morgan Pringle met with Facility Representative Nada Huseni for an Unannounced Required 1-Year Inspection. During the inspection were sixteen (16) preschool age children and four (4) staff members. LPA toured one (1) classroom for a health and safety inspection. This facility is a Title V school and is located in room K02 on the Live Oak Elementary School Campus. The facility operates from 11:30am – 3:00pm Monday, Tuesday, Thursday and Friday and 12:00pm – 3:00p on Wednesdays.


LPA was unable to complete the inspection during the visit due to the school day ending and teachers leaving. Inspection will be completed at a later date.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2023
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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