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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408962
Report Date: 06/05/2025
Date Signed: 06/05/2025 12:30:43 PM

Document Has Been Signed on 06/05/2025 12:30 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:DIANNE ADAIR DAYCARE AT EAGLE PEAKFACILITY NUMBER:
073408962
ADMINISTRATOR/
DIRECTOR:		JUDY ANGELFACILITY TYPE:
840
ADDRESS:800 HUTCHINSON RDTELEPHONE:
(925) 705-7255
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY: 150TOTAL ENROLLED CHILDREN: 150CENSUS: 18DATE:
06/05/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Scott JonesTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On Thursday, June 5, 2025 Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) M. Domantay met with Site Director, Scott Jones for the purpose of a pre-licensing inspection. Applicant requests a license child care center for a school age program (150 capacity), ages 4.9 years to 12 years, to serve a total of 150 children. The program will operate Monday through Friday from 7:00 a.m. to 6:00 p.m. The fire clearance was granted and approved on 7/18/2023 from the Contra Costa County Fire Protection Department. The facility will provide snacks for children. Applicant submitted letter/Certification, license Agreement signed by Executive Director/Principal Michelle Hammons with dates 7/1/2025 to 6/30/2026.

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

INDOOR ACTIVITY SPACE:
There are 2 school age areas designated for the school age program: Room 601 and Room 602. No measurements were taken during today's inspection. Facility is exempt from square footage due to operating on the premises of Eagle Peak Montessori School. LPA observed a sufficient amount of equipment, toys, tables, and chairs. LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Medications will be stored in Room 602 in a locked cabinet. LPA observed a functional carbon monoxide detector in Room 601 and 602. School age children have 6 toilets and 3 sinks in the girls bathroom and 2 toilets, 4 urinals, and 3 sinks in the boys bathroom. LPA observed an electronic sign-in/sign-out system.

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NAME OF LICENSING PROGRAM MANAGER: Michael Duarte
NAME OF LICENSING PROGRAM ANALYST: Melissa Domantay
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: DIANNE ADAIR DAYCARE AT EAGLE PEAK
FACILITY NUMBER: 073408962
VISIT DATE: 06/05/2025
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There is a separate private restroom for the staff located within the facility. Children who become ill during the day will be isolated in the resource room and/or corner by the Director's Desk in Room 2 and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is 1 outdoor school age activity space. The school age outdoor play areas is fenced with a metal chain linked fencing that is at least four feet tall. LPA observed a sufficient amount of equipment and toys. There is a play structure present in the outdoor play yard area. The manufacturer sticker states it is for children 5 to 12 years. The play structure is surrounded by rubber matting as cushioning to cushion a child's fall. There are shaded areas supplied by trees. The playground is free of debris and other hazards. There are no pools, hot tubs, or other bodies of water present. LPA reminded Director, Scott Jones to ensure to empty all water tables when not in use.

LPA discussed 100% supervision is always required in all areas that children have access to including the
bathroom. Personal Rights, inspection authority, reporting requirements, maintaining buildings and grounds
was reviewed. Staff Qualifications, Staff to Children’s ratios and Capacity was explained to ensure
compliance. LPA discussed with Applicant any changes that may occur regarding the director or an employee acting in the director’s absence must be reported to the department within 10 working days.

Applicant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.



Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and
stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other
important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information
website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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NAME OF LICENSING PROGRAM MANAGER: Michael Duarte
NAME OF LICENSING PROGRAM ANALYST: Melissa Domantay
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: DIANNE ADAIR DAYCARE AT EAGLE PEAK
FACILITY NUMBER: 073408962
VISIT DATE: 06/05/2025
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Exit interview conducted and report was reviewed with Director, Scott Jones.
The following items are required before a license will be issued:

1. Regional Manager (RM) final file review.

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NAME OF LICENSING PROGRAM MANAGER: Michael Duarte
NAME OF LICENSING PROGRAM ANALYST: Melissa Domantay
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
LIC809 (FAS) - (06/04)
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