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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410517924
Report Date: 04/26/2024
Date Signed: 04/26/2024 12:40:04 PM

Document Has Been Signed on 04/26/2024 12:40 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:PENINSULA COVENANT CHURCH AFTERCAREFACILITY NUMBER:
410517924
ADMINISTRATOR/
DIRECTOR:		CARRION, MEGANFACILITY TYPE:
840
ADDRESS:3560 FARM HILL BLVD.TELEPHONE:
(650) 365-8094
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 140TOTAL ENROLLED CHILDREN: 140CENSUS: 0DATE:
04/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Susan Linkwitz TIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On April 26h, 2024 at approximately 12:20pm, Licensing Program Analyst(LPA) Maria Olguin-Leon conducted an unannounced Case Management inspection. Purpose of the inspection was to hand deliver the appeal decision correspondence letter to the facility. LPA met with Program Manager, Susan Linkwitz and explained the purpose of the inspection. Present in the facility are Program Manager and no children. All adults working in the facility are fingerprint cleared and associated to the facility. Facility is currently operating within teacher to child ratio on this date.


Exit interview was conducted and report was reviewed by Program Manager, Susan Linkwitz..
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2024
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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