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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070210062
Report Date: 02/25/2025
Date Signed: 02/25/2025 04:41:13 PM

Document Has Been Signed on 02/25/2025 04:41 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:FOUNTAINHEAD MONTESSORI SCHOOLFACILITY NUMBER:
070210062
ADMINISTRATOR/
DIRECTOR:		SAMAR SHAKALIAFACILITY TYPE:
850
ADDRESS:939 EL PINTADO ROADTELEPHONE:
(925) 820-6250
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY: 92TOTAL ENROLLED CHILDREN: 79CENSUS: 27DATE:
02/25/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:00 PM
MET WITH:Samar ShakaliaTIME VISIT/
INSPECTION COMPLETED:
04:55 PM
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On 2/25/2025, at 4:00PM, Licensing Program Analyst (LPA) Janai McClain, arrived at the facility for an unannounced case management visit to inspect new flooring installed on the already existing playground. LPA met with Director Samar Shakalia. LPA toured the playground with the director. LPA observed Pour-in-Place rubber material underneath the playground structure and slides as cushioning.

This facility is approved to use the playground as of today 2/25/2025.

Report was reviewed with the director. Appeal rights were given and discussed. Notice of site visit was given and must remain posted for 30 days. Report reviewed with the director, Samar Shakalia.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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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