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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201094
Report Date: 09/21/2021
Date Signed: 09/21/2021 11:40:58 AM

Document Has Been Signed on 09/21/2021 11:40 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:WORKING WONDERSFACILITY NUMBER:
079201094
ADMINISTRATOR:SCHWAB, CHRISTINEFACILITY TYPE:
775
ADDRESS:150 MIDDLEFIELD CT SUITE FTELEPHONE:
(925) 331-7797
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY: 24CENSUS: 0DATE:
09/21/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH: CHRISTINE SCHWABTIME COMPLETED:
12:10 PM
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On 9/21/2021 at 10:10 AM, Licensing Program Analyst (LPA), L. Ibo arrived announced to conduct a pre-licensing inspection. LPA met with Christine Schwab, Administrator. Currently there are no clients and business is not in operation. The facility has a fire clearance approved for a capacity of twenty four (24) clients, 2 non-ambulatory and 22 ambulatory clients.

LPA L. Ibo toured facility with Christine Schwab. LPA inspected the facility inside including but not limited to, isolation room, common areas, computer area, and 2 bathrooms. There is a loft area on the back of the facility that will be inaccessible to clients. Future clients will be using the back-door area to enter the facility and to conduct covid19 screening. Facility is clean and in good repair. Smoke detector and carbon monoxide detector are interconnected to the building. First aid kit is complete. Fire extinguisher was last serviced on June 2021. Water temperature measures bathrooms is 106.6 degrees Fahrenheit. Currently no knives in the facility. Facility will provide snacks for clients.

Facility will be transporting clients. There are 2 vans available but parked after hours at another location. Per Administrator/Applicant registration and insurance are current.

Component III was waived. LPA discussed with Administrator/Applicant the most common deficiencies from 2019 for Adult day programs.

No issues noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required.
Exit interview conducted with Christine Schwab, Administrator/Applicant. Copy of report given.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Leslie Ibo
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2021
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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