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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408260
Report Date: 02/07/2024
Date Signed: 02/07/2024 10:29:31 AM

Document Has Been Signed on 02/07/2024 10:29 AM - 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:CREATIVE MONTESSORI PRESCHOOLFACILITY NUMBER:
073408260
ADMINISTRATOR:AKTER, SILVIAFACILITY TYPE:
850
ADDRESS:1350 MORAGA WAYTELEPHONE:
(925) 377-8314
CITY:MORAGASTATE: CAZIP CODE:
94556
CAPACITY: 23TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
02/07/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Silvia AkterTIME COMPLETED:
10:45 AM
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On 02/07/2024 at 10:10 AM Licensing Program Analysts (LPA), A. Curry and C. Watts conducted an unannounced case management inspection in regards to a lead exceedance at the facility. LPA verified that an outlet that had a lead exceedance was permanently removed and capped off. No deficiencies are being cited today.


Exit interview conducted, appeal rights were given, and report was reviewed with the Director, Silvia Akter.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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