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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406632
Report Date: 11/26/2019
Date Signed: 11/26/2019 02:13:44 PM

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:CHILD DAY SCHOOL, LLC - LAFAYETTEFACILITY NUMBER:
073406632
ADMINISTRATOR:MARIA C. ASUNCIONFACILITY TYPE:
850
ADDRESS:1049 STUART STREETTELEPHONE:
(925) 284-7092
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY:83CENSUS: 51DATE:
11/26/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Rachel Baisch, Assistant DirectorTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Redmond, conducted an unannounced, Case Management - Other visit to the facility on this date to deliver reports issued on 11/22/2019. During the visit, LPA met with Rachel Baisch, Assistant Director.

LPA discussed the reports with Ms. Baisch and answered questions regarding the reports. LPA extended Plan of Correction due dates to 12/4/2019 in order to provide the facility with additional training time and due to delay in issuing written reports.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen RedmondTELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019
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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