<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010205449
Report Date: 10/19/2020
Date Signed: 01/10/2021 10:05:24 AM

Document Has Been Signed on 01/10/2021 10:05 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:LAKE SCHOOL (THE)FACILITY NUMBER:
010205449
ADMINISTRATOR:LAURA BYESFACILITY TYPE:
850
ADDRESS:304 LESTER AVENUETELEPHONE:
(510) 839-6774
CITY:OAKLANDSTATE: CAZIP CODE:
94606
CAPACITY: 46TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/19/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Maia GalloTIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/19/20 at 3:15pm, Licensing Program Analyst (LPA) Loretta Dyson conducted a case management tele-inspection thru the FaceTime application. A tele-inspection was done due to the COVID-19 pandemic. LPA met with Maia Gallo. There were no children present. The center has submitted a waiver request to add the garage as an extension of the outdoor play area. Ms. Gallo stated that there will be no other changes.

The inspection was conducted with Ms. Gallo pointing the camera around the garage. LPA observed that the garage is set up with age appropriate activities and furniture. The garage has double doors and a single side door entrance. Ms. Gallo advised that the doors remain open during operating hours, and LPA observed that the doors lead right out to the outdoor play area. There is a ladder leading up to a loft area. The garage has a fully charged 2A10BC fire extinguisher, smoke detector, and working carbon monoxide detector. Ms. Gallo advised that the garage was approved by the fire department this morning.

The garage will be approved as an extension of the outdoor play area when the fire clearance report is received from the fire department. This report will remain on file for 3 years. There are no deficiencies being cited. An electronic signature will not be obtained from the licensee, but the report will be mailed to the licensee for signature.
Mayla Mendoza
Loretta Dyson
DATE: 10/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1