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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406683
Report Date: 09/13/2021
Date Signed: 09/13/2021 09:36:54 AM

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:WOOD ROSE ACADEMY AND PRESCHOOLFACILITY NUMBER:
073406683
ADMINISTRATOR:CHARINA OPINIONFACILITY TYPE:
850
ADDRESS:4347 COWELL ROADTELEPHONE:
(925) 825-4644
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY:72CENSUS: 49DATE:
09/13/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Harisdelsy CardenasTIME COMPLETED:
09:55 AM
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On 09/13/21 at 8:45 AM, Licensing Program Analyst (LPA), Melissa Guirit, conducted an unannounced Plan of Correction (POC) inspection. LPA met with Director, Harisdelsy Cardenas. Per Director, the carbon monoxide detectors are arriving from Amazon today. The status of the shipping was shown as proof that it will be arriving today. Director was asked to email LPA a copy of the order and to email a picture of the placement of the carbon monoxide detectors once they are received.

Per Director, as parents come to the facility, the LIC 9224 and report is being provided to the parents and a signed copy is being returned and will be placed in the specific child's file.

The type A deficiency cited on 09/10/21 will be cleared today, 09/13/21.

There are no additional citations being cited today. This report shall remain on file for 3 years. Copy of report, appeal rights, and Notice of Site Visit are given to Director. Exit interview conducted with Director, Harisdelsy Cardenas.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa GuiritTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2021
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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