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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201145
Report Date: 08/10/2022
Date Signed: 08/10/2022 03:05:36 PM

Document Has Been Signed on 08/10/2022 03:05 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:HEARTWOOD VILLASFACILITY NUMBER:
079201145
ADMINISTRATOR:ARNANTE, CLAUDIOFACILITY TYPE:
735
ADDRESS:1561 HEARTWOOD DRIVETELEPHONE:
(925) 687-1230
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY: 4CENSUS: 4DATE:
08/10/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:CLAUDIO ARNANTETIME COMPLETED:
03:15 PM
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LPA conducted Component III with Licensee, Administrator, Administrator in training and Campus Director during Tele-visit. LPA presented Component III Power Point and discussed the regulations embodied in the presentation.


Exit interview conducted and a copy of this report will be emailed.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2022
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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