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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408280
Report Date: 10/28/2021
Date Signed: 10/28/2021 12:16:02 PM

Document Has Been Signed on 10/28/2021 12:16 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:FOOTPRINTS PRESCHOOLFACILITY NUMBER:
073408280
ADMINISTRATOR:WELDON, TRACIFACILITY TYPE:
850
ADDRESS:50 WOODSWORTH LNTELEPHONE:
(925) 685-7354
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 21DATE:
10/28/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Traci WeldonTIME COMPLETED:
09:45 AM
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On 10/28/21 at 9:00 AM Licensing Program Analyst (LPA) Monica Mathur conducted a Case Management inspection at Footprints Preschool. LPA met with Director Traci Weldon and informed the purpose for inspection.

On 10/1/21 Center self reported an unusual incident that occurred where a child fell in the play yard and sustained injury requiring medical treatment. LPA did a walk through with Director of location where the incident happened, reviewed supervision and procedures that were followed. LPA did not find any lack of supervision or violation of CCL regulations. Director was reminded the importance of visual supervision at all times.

No deficiency was cited. Exit interview was conducted with Traci Weldon. A Notice of Site Visit was issued, must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2021
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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