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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401855
Report Date: 06/23/2022
Date Signed: 06/23/2022 10:52:54 AM


Document Has Been Signed on 06/23/2022 10:52 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:ALAMO COUNTRY SCHOOLFACILITY NUMBER:
073401855
ADMINISTRATOR:LISA PAGEFACILITY TYPE:
850
ADDRESS:1261 LAVEROCK LANETELEPHONE:
(925) 406-4332
CITY:ALAMOSTATE: CAZIP CODE:
94507
CAPACITY:64CENSUS: 43DATE:
06/23/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Amala FransTIME COMPLETED:
11:00 AM
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On 6/23/22 at 9:30 AM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Case Management inspection about an unusual incident self reported by the Center. LPA met with assistant director Amala Frans and explained the purpose of today's inspection.

During today's visit LPA conducted staff interviews and collected relevant documents.

There are no deficiencies cited during today's visit. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the assistant director Amala Frans.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle SuttonTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/23/2022
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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