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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408280
Report Date: 04/29/2021
Date Signed: 04/29/2021 11:41:42 AM

Document Has Been Signed on 04/29/2021 11:41 AM - 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) 685-7353
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 32TOTAL ENROLLED CHILDREN: 0CENSUS: 27DATE:
04/29/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Traci WeldonTIME COMPLETED:
11:00 AM
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On 04/29/21 at 11:00 AM Licensing Program Analysts (LPAs) Monica Mathur and Michelle Sutton conducted an unannounced Case Management inspection at Foothills Preschool. LPAs met with Director, Traci Weldon and explained the purpose of today's inspection. LPAs discussed COVID policies and procedures Center has implemented, conducted interviews, reviewed records and files, obtained relevant documents.

No deficiency was cited today.

At 11:30 AM exit interview was conducted with Director, Traci and copy of report was provided to her.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2021
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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