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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
010206027
Report Date:
03/12/2025
Date Signed:
03/12/2025 01:15:54 PM
Document Has Been Signed on
03/12/2025 01:15 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:
ST. VINCENT'S DAY HOME
FACILITY NUMBER:
010206027
ADMINISTRATOR/
DIRECTOR:
YOUNGBLOOD, JENNIFER
FACILITY TYPE:
850
ADDRESS:
1086 8TH STREET
TELEPHONE:
(510) 832-8324
CITY:
OAKLAND
STATE:
CA
ZIP CODE:
94607
CAPACITY:
261
TOTAL ENROLLED CHILDREN:
191
CENSUS:
140
DATE:
03/12/2025
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:
Alexandra Hilario and David Rodriguez
TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Cherie Acosta and Kayla Merchant conducted an unannounced Case Management visit regarding an incident that was self reported on 1/29/25.
During the visit LPAs conducted interviews. LPAs obtained a copy of the personnel report and facility roster.
There are no deficiencies cited today in regards to the incident reported on 1/29/25.
Notice of Site Visit was provided and must be posted for 30 days.
Exit interview and report reviewed with Alexandra Hilario and David Rodriguez.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Cherie Acosta
LICENSING EVALUATOR SIGNATURE
:
DATE:
03/12/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/12/2025
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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