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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009962
Report Date: 01/25/2024
Date Signed: 01/25/2024 02:58:58 PM

Document Has Been Signed on 01/25/2024 02:58 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:VCUSD-LOMA VISTA CDC P/SFACILITY NUMBER:
483009962
ADMINISTRATOR:RUND, JENNIFERFACILITY TYPE:
850
ADDRESS:146 RAINIER STREETTELEPHONE:
(707) 556-8550
CITY:VALLEJOSTATE: CAZIP CODE:
94589
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 6DATE:
01/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Corinna CalicaTIME COMPLETED:
03:15 PM
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Licensing Program Analyst, Genn Ouye met with the Child Development Coordinator, Corinna Calica to conduct a staff record review and discuss the bathroom waiver that is in review for this preschool site.
Five staff records were reviewed in conjunction with the Annual Inspection conducted at VCUSD Loma Vista CDC Preschool.,
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2024
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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