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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405692
Report Date: 02/27/2024
Date Signed: 02/27/2024 11:51:45 AM

Document Has Been Signed on 02/27/2024 11:51 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SRVSACCA-CREEKSIDEFACILITY NUMBER:
073405692
ADMINISTRATOR:SAMS, DANIFACILITY TYPE:
840
ADDRESS:6055 MASSARA STTELEPHONE:
(925) 743-3170
CITY:DANVILLESTATE: CAZIP CODE:
94506
CAPACITY: 188TOTAL ENROLLED CHILDREN: 188CENSUS: 0DATE:
02/27/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Ian GarciaTIME COMPLETED:
12:00 PM
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On 2/27/2024 at 11:45 am Licensing Program Analyst (LPA) arrived at Creekside Elementary School: San Ramon Valley Kid's Country to conduct a Case Management- Licensee Initiated visit. The facility has opened a new building and has requested to use it for the program. LPA was met by site director Ian Garcia. There were no children present during the inspection. However, the site director advises 95 students are currently enrolled.

LPA toured the new building for a health and safety inspection with site director Ian Garcia. In the building there are two main rooms; Room 1 will be used for T-K and Kinder, Room 2 will be used for 2nd-5th grade. Site director Ian Garcia confirmed that 1st graders will still be using the room within Creekside Elementary School. The building has a separate playground that includes 1 play structure, tables and a basketball court. Shade is provided by way of covered areas. Water is made available both for indoors and outdoor activities. The building also includes 3 restrooms, 2 of which are used for the children.

Based upon observation there were no regulatory violations cited today.

Exit interview conducted with Ian Garcia. A notice of site visit was provided to be posted for 30 consecutive days and appeal rights for review.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
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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