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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405009
Report Date: 02/22/2023
Date Signed: 02/22/2023 02:58:38 PM

Document Has Been Signed on 02/22/2023 02:58 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:KID'S HIDEOUTFACILITY NUMBER:
073405009
ADMINISTRATOR:BROWN, BETHFACILITY TYPE:
840
ADDRESS:3309 SPRINGHILL ROADTELEPHONE:
(925) 283-7808
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 49DATE:
02/22/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Elizabeth BrownTIME COMPLETED:
03:15 PM
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On 2/22/23, Licensing Program Analysts (LPAs) Melissa Domantay and Melissa Guirit conducted a case management inspection at this facility. LPAs met with owner, Elizabeth Brown. There were 49 children present. An application was received with a request to add rooms to the license, Rooms K1, K2, K3, 15, 16, 17, 18, and Staff Break Room. The facility will operate Monday-Friday 7:00am-6pm on the grounds of the Springhill Elementary School.

A tour of the Rooms K1, K2, K3, 15, 16, 17, 18, and Staff Break Room was conducted for a health and safety inspection with owner Elizabeth Brown. LPAs did not observe any hazardous items, defects or dangerous conditions. Each room has a fully charged fire extinguisher and centralized combination carbon monoxide/smoke detection system. An updated superintendent's certification, indicating that Rooms K1, K2, K3, 15, 16, 17, 18, and Staff Break Room can be used by the child care facility was received from Owner, Elizabeth Brown. A fire clearance, dated 1/6/23, was received from the Contra Costa County Fire Protection Department.

Rooms K1, K2, K3, 15, 16, 17, 18, and Staff Break Room will be added to the school age license effective 2/22/23 with a capacity of 120 children. There are no deficiencies being cited. An exit interview was conducted with Owner Elizabeth Brown and appeal rights were provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2023
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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