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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407476
Report Date: 09/02/2021
Date Signed: 09/02/2021 12:33:38 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:BLACKHAWK MONTESSORIFACILITY NUMBER:
073407476
ADMINISTRATOR:BARI, NAVEEDA & PATEL, N.FACILITY TYPE:
850
ADDRESS:3380 BLACKHAWK PLAZA CIR,ST112TELEPHONE:
(925) 575-7212
CITY:DANVILLESTATE: CAZIP CODE:
94506
CAPACITY:70CENSUS: 53DATE:
09/02/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Naveeda Bari and Naureen PatelTIME COMPLETED:
01:00 PM
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On 09/02/21 at 10:30 AM, Licensing Program Analysts (LPAs) Melissa Domantay and Melissa Guirit arrived at the facility for an unannounced case management inspection. LPA met with licensees Naveeda and Naureen. The normal hours of operation are Monday-Friday 7:00am-6pm. An application was received for an increase in capacity. There are four additional classrooms and outdoor play space that has been added to the facility. There are no changes to the bathrooms and outdoor space that were previously licensed. LPAs toured the new preschool rooms and a small section outdoor play area to conduct a health and safety inspection, and completed the following measurements:

INDOORS: 5050.51 square feet = 144 children
OUTDOORS: 6349.41 square feet = 84 children
All other indoor and outdoor measurements remain the same. A fire clearance was received from the San Ramon Valley Fire on 08/25/21.

LPAs observed that there is sufficient heating, lighting and ventilation in the classrooms, and the classroom floors and surfaces are clean and free of hazards. The rooms have an ample supply of age appropriate furniture, toys and equipment which appear to be in good condition. LPAs did not observe any bodies of water, hazardous items or toxins that would be accessible to children. The new outdoor play area is an extension to the already licensed outdoor space. LPAs observed operating sinks and covered waste cans. The rooms are equipped with fully charged 3A40BC fire extinguishers, carbon monoxide detectors and centralized smoke detection systems. The facility has a working telephone and first aid supplies.

The new preschool classrooms, extended outdoor play area, and license for a capacity of 144 children will be made part of the license once an updated outdoor waiver is submitted to LPA. There are no deficiencies being cited today. This report will remain on file for 3 years. A Notice of Site inspection was provided to the licensee, and an exit interview was conducted.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa GuiritTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021
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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