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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079200383
Report Date: 12/21/2023
Date Signed: 12/21/2023 12:54:34 PM

Document Has Been Signed on 12/21/2023 12:54 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
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:SVS CONCORD ADULT DAY PROGRAMFACILITY NUMBER:
079200383
ADMINISTRATOR:SHAVILA WRIGHTFACILITY TYPE:
775
ADDRESS:2300 STANWELL DRIVE SUITE BTELEPHONE:
(925) 849-8750
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY: 60CENSUS: 18DATE:
12/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Shanay McDonald, Program DirectorTIME COMPLETED:
12:30 PM
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On 12/21/2023 at 12:15 PM, Licensing Program Analysts (LPA) P. Watson arrived unannounced to deliver amended report for visit conducted on 12/04/2023. LPA met with Program Director, Shanay McDonald and explained the purpose of the visit.

Amended report was delivered to Program Director.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Paris Watson
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2023
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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