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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408919
Report Date: 05/11/2022
Date Signed: 05/11/2022 02:51:41 PM

Document Has Been Signed on 05/11/2022 02:51 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 TIME, INC.FACILITY NUMBER:
073408919
ADMINISTRATOR:CASWELL, ANGELAFACILITY TYPE:
850
ADDRESS:2551 PLEASANT HILL ROADTELEPHONE:
(925) 930-6550
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 29TOTAL ENROLLED CHILDREN: 29CENSUS: DATE:
05/11/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Angela CaswellTIME COMPLETED:
03:00 PM
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On 5/11/22 at 2:00 pm Licensing Program Analysts (LPAs) Monica Mathur and Christina Watts conducted an unannounced Case Management inspection at Kid Time Inc. Purpose of inspection is to give an amended 809 report of inspection conducted on 5/9/22.

LPAs met with Director Angela Caswell and explained the purpose of todays inspection. She has submitted the plans of correction to Licensing and deficiencies of 5/9/22 are cleared. Letter of Clearance was given.

Amended report 809 and 809D pages was reviewed with Director. Notice of Site Visit was issued, must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2022
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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