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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407850
Report Date: 03/29/2021
Date Signed: 03/29/2021 10:39:39 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:BADER, LILIANEFACILITY NUMBER:
073407850
ADMINISTRATOR:BADER, LILIANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 455-5062
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:14CENSUS: 7DATE:
03/29/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Liliane BaderTIME COMPLETED:
10:50 AM
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced case management inspection. During the course of a complaint investigation LPA noticed that the licensee's pool fence did not meet licensing requirements. Licensee's fence measures at 4 feet high. The fence does have a self latching gate that opens away from the pool. Licensee is given technical assistance and agrees to ensure the fence meets the requirement of 5 feet in height within 30 days.

Exit interview conducted with Liliane Bader.
Appeal rights were provided.
Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie AcostaTELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2021
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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