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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019201428
Report Date: 02/13/2025
Date Signed: 02/13/2025 02:24:03 PM

Document Has Been Signed on 02/13/2025 02:24 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:FCSN ADAPTIVE SKILLS TRAININGFACILITY NUMBER:
019201428
ADMINISTRATOR/
DIRECTOR:		CHIAO, LINMEIFACILITY TYPE:
775
ADDRESS:2190 PERALTA BLVD.TELEPHONE:
(510) 739-6900
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 20CENSUS: 0DATE:
02/13/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:35 PM
MET WITH:Linmei Chiao, Program Director TIME VISIT/
INSPECTION COMPLETED:
02:35 PM
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On 02/13/2025, at 1:35 PM, Licensing Program Analysts (LPAs) P.Manalo and L. Fontanilla conducted a Component III presentation. LPAs met with Program Director, Linmei Chiao and Assistant Program Director, Amanda Hsu.

LPAs presented Component III power point and discussed the regulations embodied in the presentation.

LPAs concluded Component III.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Patricia Manalo
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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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