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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405685
Report Date: 11/29/2022
Date Signed: 11/29/2022 04:06:36 PM

Document Has Been Signed on 11/29/2022 04:06 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:HAPPY LION DAY CARE CENTERFACILITY NUMBER:
073405685
ADMINISTRATOR:CHAVIS, WEDNESDAYFACILITY TYPE:
850
ADDRESS:2929 CASTRO ROADTELEPHONE:
(510) 734-9119
CITY:SAN PABLOSTATE: CAZIP CODE:
94806
CAPACITY: 29TOTAL ENROLLED CHILDREN: 29CENSUS: 5DATE:
11/29/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:37 PM
MET WITH:Wednesday ChavisTIME COMPLETED:
04:20 PM
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On Tuesday, November 29, 2022 at 2:37 PM, Licensing Program Analyst (LPA) Caroline Colson met with Betty Hill, Teacher, and Tina Gamez, Teacher, for an unannounced case management inspection. There are five (5) children present two staff members. Wednesday Chavis and Tina Gamez arrived during the inspection. The purpose of the inspection was to review the menu and meals served at the facility. The meals are being provided by the school district.

There were no deficiencies cited during this inspection. An exit interview was conducted. Appeal Rights were given.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2022
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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