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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343603013
Report Date: 11/13/2019
Date Signed: 11/13/2019 04:32:35 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:KINDERCARE LEARNING CENTER - PEETS (SA)FACILITY NUMBER:
343603013
ADMINISTRATOR:ROWE, NICOLEFACILITY TYPE:
840
ADDRESS:9150 PEETS STREETTELEPHONE:
(916) 684-9284
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:28CENSUS: 23DATE:
11/13/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:21 PM
MET WITH:Casey AlvaradoTIME COMPLETED:
02:57 PM
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Licensing Program Analyst (LPA) Jeevun Birk-Miller conducted an unannounced Case Management Inspection and met with Director, Casey Alvarado. Upon arrival 23 children were present. LPA inspected the facility and confirmed the confirmation of removal for an individual that was associated to the facility has been completed. Casey stated she had filled out the LIC300D and submitted the form to the Regional Office. LPA confirmed that the individual, Palak Shah was not present at the facility. Casey stated this individual has not worked at the facility since Casey became the Director.

No Title 22 Deficiencies were observed in the areas that were evaluated and the facility was in substantial compliance. LPA read this report to the licensee; she stated that understands today’s inspection. Notice of Site Visit posted and the licensee understands it must remain posted for 30 days.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun BirkTELEPHONE: (916) 917-6078
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019
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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