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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421071
Report Date: 05/05/2023
Date Signed: 05/05/2023 11:45:10 AM

Document Has Been Signed on 05/05/2023 11:45 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
OAKLAND SOUTH EAST, 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: 1DATE:
05/05/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Alpa Nagar TIME COMPLETED:
12:55 PM
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On May 5, 2023 License Program Analyst (LPA) Lorraine Dacanay Breaux met with Licensee Alpa Nagar for a Case Management-Other Inspection. During today's inspection was the licensee and one child in care. Licensee A. Nagar requested that the rear yard be off limits effective today May 5, 2023 due to remodeling the rear yard. The start of the remodeling will be May 6, 2023. Licensee is reminded that before the children can go outdoors to play, LPA has to be notified and will need to inspect to put on limits. Licensee states the work should take about 1 month weather permitting.

Exit interview conducted with Licensee Alpa Nagar. Appeal Rights Provided. Notice of site visit given and must remain posted for 30 days.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2023
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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