<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009973
Report Date: 09/30/2021
Date Signed: 09/30/2021 10:31:55 AM

Document Has Been Signed on 09/30/2021 10:31 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:VCUSD GLEN COVE CDC P/SFACILITY NUMBER:
483009973
ADMINISTRATOR:CLAUDETTE, KELLYFACILITY TYPE:
850
ADDRESS:501 GLEN COVE PARKWAYTELEPHONE:
(707) 556-8491
CITY:VALLEJOSTATE: CAZIP CODE:
94591
CAPACITY: 48TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
09/30/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Claudette KellyTIME COMPLETED:
10:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Glenn Ouye met with Claudette Kelly to conduct a case management visit for the purpose of the program replacing room C4 with room A5. Room DK will still be used by the program.

New room A5 is slightly larger than room the room it is replacing. There are sufficient sinks and toilets to serve the children in care. Both classrooms will utilize the outdoor play area which is just outside of classroom DK. Children in room A5 will be escorted to the outdoor play area when it is to be used.

LPA Ouye is still waiting for the approved fire inspection from the City of Vallejo, but the fire inspector has been out to the school to conduct the inspection.

Upon receipt of the approved fire clearance, classroom A5 will be approved for use by the program.



No deficiencies during the inspection.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1