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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421071
Report Date: 06/24/2022
Date Signed: 06/24/2022 02:08:39 PM

Document Has Been Signed on 06/24/2022 02:08 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 1102
OAKLAND, CA 94612
FACILITY NAME:NAGAR, ALPAFACILITY NUMBER:
013421071
ADMINISTRATOR:NAGAR, ALPAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 425-0061
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/24/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Alpa NagarTIME COMPLETED:
02:15 PM
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On June 24, 2022, Licensing Program Analyst (LPA) Lorraine Dacanay Beaux arrived for a case management inspection. LPA met with licensee Alpa Nagar. There were no children in care.

The purpose of today's inspection was to reinspect the rear yard, it was placed off limits, due to healthy and safety. Licensee added 16 safety cones and extra safety gates through out the rear yard to prevent children from entering the areas of concern. Licensee covered and secured the barbecue pit. Rear end of the deck, the wood has been secured.

LPA Dacanay Breaux is adding the rear yard to on limits area.

On limits area consist of the family room, living room, kitchen, bathroom on first floor in hallway (across from the garage) and rear yard. Off Limits: The entire second floor is off limits, all upstairs bedrooms, including master bedroom/bathroom, the bedroom located on the first floor, garage, and front yard.

There are no deficiencies cited today.

Exit interview conducted with licensee Alpa Nagar and copy of report provided. A notice of site visit and appeal rights was provided and must remain posted for 30 days
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2022
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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