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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073403058
Report Date: 08/11/2023
Date Signed: 08/11/2023 11:12:40 AM


Document Has Been Signed on 08/11/2023 11:12 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:MONTESSORI SCHOOL OF BRENTWOOD, INC.FACILITY NUMBER:
073403058
ADMINISTRATOR:SHAKUNTALA, CHHAGANFACILITY TYPE:
850
ADDRESS:3421 BALFOUR ROADTELEPHONE:
(925) 516-2111
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:120CENSUS: 50DATE:
08/11/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Shakuntala (Shaku) ChhaganTIME COMPLETED:
11:30 AM
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Licensing Program Analyst Cherie Acosta conducted an unannounced case management inspection. LPA met with Director Shakuntala (Shaku) Chhagan.

The facility replaced the play yard wooden fence with a masonry wall. Director was in communication with Community Care Licensing prior to and during the wall construction.
During today's inspection, the play yard and masonry wall was inspected. The play yard and masonry wall was observed to be safe for children.

There are no deficiencies cited during today's inspection.
Exit interview and report reviewed with Shakuntala (Shaku) Chhagan
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie AcostaTELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:
DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2023
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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