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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019201359
Report Date: 07/22/2024
Date Signed: 07/22/2024 11:37:39 AM

Document Has Been Signed on 07/22/2024 11:37 AM - 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, STE. 310
OAKLAND, CA 94612
FACILITY NAME:FCSN L.E.A.D. ADULT TRAINING PROGRAMFACILITY NUMBER:
019201359
ADMINISTRATOR/
DIRECTOR:		YEH, SYLVIAFACILITY TYPE:
775
ADDRESS:42080 OSGOOD RD SUITE 101TELEPHONE:
(510) 739-6900
CITY:FREMONTSTATE: CAZIP CODE:
94539
CAPACITY: 75CENSUS: 0DATE:
07/22/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Vivian Largusa, Program Director
Sylvia Yeh, Executive Director		TIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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On 7/22/2024 at 9:15AM, Licensing Program Analyst (LPA) G. Luk conducted a Pre-licensing Inspection. LPA met with Program Director, Vivian Largusa and Executive Director, Sylvia Yeh.


LPA toured facility including but not limited to classrooms, quiet room, bathrooms, kitchen area, and other common areas. LPA observed lighting in all rooms. Smoke detectors are interconnected with sprinkler system. Carbon monoxide detector was observed in operating condition. First aid kit was complete. Emergency disaster plan was complete. Fire extinguisher was observed to be full and last served on 8/25/2023.

The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB):

1. Hot water was measured at 132.2 degrees F in the hallway bathroom sink. Director lowered hot water and re-measured hot water at 103 degrees F.

2. LPA observed facility's plan of operations does not address when client is missing from the facility. LPA requested an updated copy of the plan of operations.

Licensee/Applicant will submit proof of corrections to CCLD on/before 7/26/2024.


Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2024
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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