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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
073401411
Report Date:
02/13/2024
Date Signed:
02/13/2024 02:00:08 PM
Document Has Been Signed on
02/13/2024 02:00 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, SUITE 1102
OAKLAND
,
CA
94612
FACILITY NAME:
CONTRA COSTA COUNTY HEAD START - MARSH CREEK
FACILITY NUMBER:
073401411
ADMINISTRATOR:
AFI FIAXE
FACILITY TYPE:
850
ADDRESS:
7251 BRENTWOOD BLVD
TELEPHONE:
(925) 427-8576
CITY:
BRENTWOOD
STATE:
CA
ZIP CODE:
94513
CAPACITY:
36
TOTAL ENROLLED CHILDREN:
27
CENSUS:
10
DATE:
02/13/2024
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME BEGAN:
10:30 AM
MET WITH:
Afi Fiaxe
TIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced visit in regards to a self reported incident. LPA met with Director Afi Fiaxe. There were 4 staff and 10 children present when LPA arrived.
During the visit LPA conducted interviews.
There are no deficiencies cited during today's visit.
Exit interview and report reviewed with Afi Fiaxe
Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Cherie Acosta
LICENSING EVALUATOR SIGNATURE
:
DATE:
02/13/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
02/13/2024
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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