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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700002
Report Date: 07/11/2022
Date Signed: 07/11/2022 02:23:24 PM

Document Has Been Signed on 07/11/2022 02:23 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:QADAR, FARISHTAFACILITY NUMBER:
015700002
ADMINISTRATOR:QADAR, FARISHTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 989-4298
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
07/11/2022
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Farishta QadarTIME COMPLETED:
02:30 PM
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July 11, 2022 LPA Lorraine Dacanay Breaux met with Licensee Farishta Qadar for an announced Case Management visit. Licensee and fingerprint clear staff was present during the Health and Safety Inspection. During the annual inspection, LPA Breaux removed the rear yard from on limits to off limits area due to the fence needing repair and the next door neighbor has a swimming pool. LPA Breaux inspected the rear/side fence, the fence has been repaired to satisfactory. LPA Breaux is putting the rear yard to a "ON LIMIT" Area. The rear yard, excluding the deck is on limits for children to play.

Notice of site visit given and appeal right provided. Exit interview with Licensee F. Qadar conducted.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 07/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/11/2022
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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