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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010205449
Report Date: 02/17/2021
Date Signed: 02/17/2021 11:39:06 PM

Document Has Been Signed on 02/17/2021 11:39 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LAKE SCHOOL (THE)FACILITY NUMBER:
010205449
ADMINISTRATOR:GALLO, MARIAFACILITY TYPE:
850
ADDRESS:304 LESTER AVENUETELEPHONE:
(510) 839-6774
CITY:OAKLANDSTATE: CAZIP CODE:
94606
CAPACITY: 46TOTAL ENROLLED CHILDREN: 0CENSUS: 25DATE:
02/17/2021
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Maia GalloTIME COMPLETED:
11:25 AM
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A Case Management Tele-Visit was conducted on this date 2/17/21 by Licensing Program Manager (LPM), Mayla Mendoza & Licensing Program Analyst (LPA) Melissa Guirit. LPM and LPA met with Director, Maria "Maia" Gallo. The center has requested to add the garage as additional outdoor play space , which was previously approved as a waiver, with no change to the current capacity. A health and safety inspection was conducted. Measurements are as follows:

Indoors: 1626 square feet = 46 children
Outdoors: 4901.717 square feet = 65 children


There were no deficiencies cited during this tele-visit.

Licensee submitted COVID-19 self-assessment guide. LPM and LPA provided technical assistance including postings.

The center can now utilize the garage as additional outdoor playspace.

An exit interview was conducted.
Diane Perez
Mayla Mendoza
DATE: 02/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2021
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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