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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408897
Report Date: 04/12/2023
Date Signed: 04/12/2023 09:13:51 AM

Document Has Been Signed on 04/12/2023 09:13 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:FOUNTAINHEAD MONTESSORI SCHOOL-PLEASANT HILLFACILITY NUMBER:
073408897
ADMINISTRATOR:RIZVI, SUMAIRAFACILITY TYPE:
850
ADDRESS:1715 OAK PARK BOULEVARDTELEPHONE:
(925) 967-2655
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 99TOTAL ENROLLED CHILDREN: 105CENSUS: 20DATE:
04/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Sumaira RizviTIME COMPLETED:
09:00 AM
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On 04/12/2023 at 8:00 AM, Licensing Program Analysts (LPAs) Christina Watts and Monica Mathur conducted a Case Management Inspection at Fountainhead Montessori School - Pleasant Hill. LPAs met with Director, Sumaira Rizvi and explained the purpose of today's inspection. During today's inspection, there was 20 children in care and 12 staff. Director stated there is 105 children enrolled.

LPA amended the case management report dated 03/22/2023 and has given amended copy to Director during today's inspection.

During today's inspection, there were no violation observed.

Exit interview conducted and report was reviewed with the Director, Sumaira Rizvi. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2023
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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