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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010211776
Report Date: 06/13/2024
Date Signed: 06/13/2024 02:40:36 PM

Document Has Been Signed on 06/13/2024 02:40 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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:HIS GROWING GROVEFACILITY NUMBER:
010211776
ADMINISTRATOR/
DIRECTOR:		JENNIFER YOUNGBLOODFACILITY TYPE:
830
ADDRESS:2490 GROVE WAYTELEPHONE:
(510) 581-5088
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 18DATE:
06/13/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Jennifer YoungbloodTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 06/13/2024 at 11:00am, Licensing Program Analysts (LPA) Christina Uribe & Jialing "Julianne" Zhu conducted an Unannounced Plan of Correction Inspection. LPA met with Site Director, Jennifer Youngblood, also present at the time of the inspection were 8 staff & 18 children. The purpose of today's visit is to review children's files and to clear the plan of correction for a previously issued.

LPA Uribe visited the facility for an annual inspection on 05/03/2024 and the facility was issued a Type B Violation on this date for incomplete children's files. CCLD requires that all children under the age of 24 months (2 years) have a Needs & Services Plan that is updated every 3 months while the child is in enrolled. On 05/03/24, LPA Uribe found during record review that all infants files did have a Needs & Services Plan but these were not being updated every 3 months resulting in the issuance of the citation.

Today, on 06/13/2024, LPA Uribe returned to the facility to clear the deficiency issued on 05/03/2024. LPA Uribe reviewed a random sample of children's files today and found that all records have a an updated Needs & Services Plan which satisfies the record keeping requirement. LPA Uribe has cleared the Plan of Correction and gave the director the proof of clearance letter.

Notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with the director, Jennifer Youngblood.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2024
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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