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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420889
Report Date: 04/20/2021
Date Signed: 04/20/2021 02:36:04 PM

Document Has Been Signed on 04/20/2021 02:36 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:LAS POSITAS COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
013420889
ADMINISTRATOR:ANGIE LOPEZFACILITY TYPE:
850
ADDRESS:3000 CAMPUS HILL DR., #2300TELEPHONE:
(925) 424-1575
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY: 132TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/20/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Angie LopezTIME COMPLETED:
02:45 PM
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On 04/20/2021 Licensing Program Analyst (LPA) Jaylena Miller conducted an unannounced case management visit and met with site director Angie Lopez for the purpose of obtaining copies of a former employees file and child rosters during their employment.

No deficiencies were cited during todays visit. Notice of site visit given and must be posted for 30 days. A copy of this report must be maintained for 3 years and available for public review upon request.

Exit interview conducted with Site Director, Angie Lopez.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE: DATE: 04/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/20/2021
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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