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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406634
Report Date: 01/17/2023
Date Signed: 01/17/2023 02:53:21 PM


Document Has Been Signed on 01/17/2023 02:53 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 STE 1102
OAKLAND, CA 94612



FACILITY NAME:CHILD DAY SCHOOL, LLC - SAN RAMONFACILITY NUMBER:
073406634
ADMINISTRATOR:MILLER, JILLIANFACILITY TYPE:
840
ADDRESS:18868 BOLLINGER CANYON RDTELEPHONE:
(925) 820-2515
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY:20CENSUS: 7DATE:
01/17/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Gabriela HerreraTIME COMPLETED:
03:05 PM
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On January 17, 2023 at 1:45pm, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced to conduct a Case Management - Legal / Non-Compliance Inspection at the school age program of this center. LPA met with assistant director Gabriela Herrera. Present at time of inspection was teacher Karen Curtiss and seven children engaging in daily activities. The purpose of the inspection is the program is currently under increased monitoring as agreed upon during the noncompliance meeting between the director and community care licensing management conducted on 3/3/22.

LPA toured the facility and observed all children to be directly supervised during the inspection. The facility is conducting emergency disaster drills as required, last of which was completed on 12/7/22. LPA verified both opening and closing staff have current CPR/First aid training. A physical census was taken of all children present and crossed referenced with the sign in/out sheets. LPA reviewed staff files which were observed to be complete and up to date. Children's files were reviewed at last inspection on 9/20/22 and there have been no changes since. LPA observed compliance with AB 633, and signed and dated LIC 9224 documentation in children's files.

No deficiencies were cited as a result of today's inspection.

Exit interview conducted with assistant director Gabriela Herrera and copy of report provided. A Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2023
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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