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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070213231
Report Date: 10/05/2022
Date Signed: 10/05/2022 11:28:46 AM


Document Has Been Signed on 10/05/2022 11:28 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:MURWOOD KEYSPOTFACILITY NUMBER:
070213231
ADMINISTRATOR:MELISSA SHERIDAN MULLERFACILITY TYPE:
840
ADDRESS:2050 VANDERSLICE AVENUETELEPHONE:
(925) 932-8118
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94596
CAPACITY:120CENSUS: 0DATE:
10/05/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Melissa SheridanTIME COMPLETED:
11:50 AM
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On 10/05/2022 Licensing Program Analysts (LPAs) Melissa Domantay and Melissa Guirit conducted an unannounced case management inspection at the facility above in regard to unusual incident that occurred on 9/29/2022 where a child took off running off campus. LPAs met with teacher, Celia Corral and Director, Melissa Sheridan. Staff Interviews were conducted with Teacher that was present during the incident and Director. Staff interviews determined that 2 staff were present supervising child when incident occurred. Director contacted child's mother and father during and after the incident that occurred.

No deficiencies being cited today.

An exit interview was conducted with Director Melissa Sheridan and report and notice of site was provided. Appeal rights provided.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Melissa DomantayTELEPHONE: 510-725-7021
LICENSING EVALUATOR SIGNATURE:
DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/05/2022
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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