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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004506
Report Date: 01/28/2022
Date Signed: 01/28/2022 01:29:38 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LAKEVIEW MONTESSORIFACILITY NUMBER:
414004506
ADMINISTRATOR:BRAMHE, SHEILAFACILITY TYPE:
850
ADDRESS:31 VISTA AVENUETELEPHONE:
(650) 578-9532
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:48CENSUS: 30DATE:
01/28/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Fidaa Aslam, Sheila BramheTIME COMPLETED:
01:30 PM
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On January 28, 2022 at 12:10 PM, Licensing Program Analyst (LPA) conducted a Case Management Inspection to follow up on items to be corrected before Room 2 can be licensed for use. LPA met initially with teacher Fidaa Aslam. Upon arrival, LPA observed that room 2 is already in use with 2 staff, Alicia Stein and shivi bhatnagar, and 6 children.

At 12:50, director, Sheila Bramhe arrives to meet with LPA. Director states that they have begun using the room just to spread out to protect from of Covid-19. During inspection, LPA observed that Classroom 2 now has a First Aid Kit, a covered trash cans, and a working carbon monoxide and smoke detector.

Upon the approval of the fire inspection, LPA recommends approval and licensure for Room 2.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
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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