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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408880
Report Date: 05/26/2022
Date Signed: 05/26/2022 02:59:44 PM


Document Has Been Signed on 05/26/2022 02:59 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, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:GARDEN COMMUNITY PRESCHOOL, THEFACILITY NUMBER:
073408880
ADMINISTRATOR:CADY, MELISSAFACILITY TYPE:
850
ADDRESS:1015 OAK GROVE ROADTELEPHONE:
(925) 671-2979
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY:39CENSUS: 34DATE:
05/26/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Haley DaughrityTIME COMPLETED:
03:30 PM
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On 05/26/2022 at 12:50 PM Licensing Program Analysts (LPAs) A. Curry, M. Mathur, and C. Watts conducted an unannounced case management inspection to follow up on a self-reported unusual incident regarding an alleged violation of personal rights. LPAs met with the assistant director Haley Daughrity to discuss the purpose of today's visit. LPAs conducted interviews and obtained facility records. Further investigation is needed. No deficiencies cited today.

An exit interview was conducted, appeal rights were given, and report was reviewed with assistant director Haley Daughrity.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley CurryTELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2022
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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