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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073402539
Report Date: 09/27/2022
Date Signed: 09/27/2022 04:54:36 PM


Document Has Been Signed on 09/27/2022 04:54 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:CATANIA, MARIAFACILITY NUMBER:
073402539
ADMINISTRATOR:CATANIA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 934-2589
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:14CENSUS: 8DATE:
09/27/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:45 PM
MET WITH:Maria CataniaTIME COMPLETED:
05:00 PM
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On 9/27/22 at 4:45PM, Licensing Program Analyst (LPA) Catherine Fernandes arrived announced on a case management inspection and met with Licensee Maria Catania.

The purpose for the inspection was to make an off limit bedroom to on limit space for the children to use. The bedroom is at the end on the hall next to the bathroom. The room has been cleared and is available for use starting today.

Exit interview conducted
Report and Appeal Rights provided
Notice of site visit must be posted for 30 days.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2022
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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