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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406632
Report Date: 11/22/2019
Date Signed: 11/22/2019 03:30:27 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: 68DATE:
11/22/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Rachel Baisch, Acting DirectorTIME COMPLETED:
03:55 PM
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Licensing Program Analyst (LPA) Redmond, conducted an unannounced, Case Management visit regarding two Complaint Investigations conducted on 11/21 and 11/22/2019. During the visits, LPA met with Rachel Baisch, Acting Director. LPA also met with Yvonne Sylvia, Program Facilitator on 11/21/19 regarding the Complaint Investigations.

LPA concluded the investigations on 11/22/19 and rendered findings. LPA reminded Rachel Baisch about the Mandated Reporter requirements and Employee Rights and advised Ms. Baisch that the facility is required to post a the "If You See Something, Say Something" poster, with the Community Care Licensing Division telephone number and address in a prominent place at the facility, where it is visible to visitors to the facility. The poster was not posted on this date. A technical advisory is given.




SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen RedmondTELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019
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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