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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401984
Report Date: 09/24/2020
Date Signed: 12/31/2020 01:12:23 AM

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:HUSKY HOUSE, INC.FACILITY NUMBER:
073401984
ADMINISTRATOR:ANN REARDENFACILITY TYPE:
840
ADDRESS:3855 HAPPY VALLEY ROADTELEPHONE:
(925) 283-7100
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY:120CENSUS: 0DATE:
09/24/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
07:00 AM
MET WITH:Anne ReardonTIME COMPLETED:
07:30 AM
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On 9/24/20 at 7am, Licensing Program Analyst (LPA) Loretta Dyson conducted a case management tele-inspection for this center. The inspection was conducted thru the FaceTime application due to the COVID-19 pandemic. LPA met with the director, Anne Reardon, and there was no one else present. The center submitted an application to add classrooms 19, 32(34) and the multi-purpose room to the license. The center is operating on the campus of Happy Valley Elementary School. The hours of operation for the school age component are Monday thru Friday 7am-6:30pm.

A health and safety inspection was conducted with Ms. Reardon using the camera to scan each space. LPA observed that the classrooms had sufficient lighting and the rooms were set up to meet social distancing recommendations. LPA observed that each space has access to a bathroom. LPA did not observe any hazardous items that would be accessible to children. LPA observed that each space is equipped with a fire extinguisher and centralized combination smoke/carbon monoxide detector. There is a working telephone and first aid supplies available on the site. Ms. Reardon provided a copy of the most recent fire inspection report for the school, from the Contra Costa County Fire Protection Department, dated 6/3/20. A Superintendent's Certification, indicating that all of the rooms are approved for use by the center, was received.

All requirements have been met and the center is approved to begin using the additional classrooms and multipurpose room, effective today 9/24/20. 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.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2020
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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