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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070211453
Report Date: 05/19/2023
Date Signed: 05/19/2023 12:46:45 PM


Document Has Been Signed on 05/19/2023 12:46 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:HOLY ROSARY SCHOOLFACILITY NUMBER:
070211453
ADMINISTRATOR:HALL, JENNIFERFACILITY TYPE:
850
ADDRESS:25 EAST 15TH STREETTELEPHONE:
(925) 757-1270
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:45CENSUS: 15DATE:
05/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Jennifer HallTIME COMPLETED:
12:50 PM
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On 05/19/2023 at 11:50 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced case management inspection at Holy Rosary School. LPA met Director, Jennifer Hall and explained the purpose of today's inspection. During today's inspection, there were 15 children in care and 38 children enrolled with 6 staff. All adults in facility have Criminal Record Clearance.

Facility was cited an Type B citation on March 30, 2023 for violation of Teacher's Qualifications and Duties. A plan of correction was received via email on April 17, 2023 when Director submitted transcripts of staff. Director stated she has contact company multiple times to become CDA certified however has not been able to get in contact with company. Director stated staff has experience teaching and provided transcripts that are in staff file.

Deficiency has been cleared as of May 19, 2023. Clearance letter was printed and provided to Director today.

There were no violation observed during today's inspection.


Exit interview was conducted and report was reviewed with the Director, Jennifer Hall. A Notice of Site Visit was given and must remain posted for 30 consecutive days.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:
DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2023
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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