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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010211909
Report Date: 07/25/2024
Date Signed: 07/25/2024 05:24:09 PM

Document Has Been Signed on 07/25/2024 05:24 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:BAHIA SCHOOL AGE PROGRAMFACILITY NUMBER:
010211909
ADMINISTRATOR/
DIRECTOR:		LUCERO, YANCIFACILITY TYPE:
840
ADDRESS:1718 - 8TH STREETTELEPHONE:
(510) 524-7300
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY: 65TOTAL ENROLLED CHILDREN: 65CENSUS: 14DATE:
07/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:40 PM
MET WITH:Yanci LuceroTIME VISIT/
INSPECTION COMPLETED:
05:35 PM
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On July 25, 2024 at 3:40pm Licensing Program Analyst (LPA) Indira Loza met with Director Yanci Lucero. The purpose of the visit was due to a self reported incident that was received at the Oakland Regional office. Present during the visit were 14 children, 4 fingerprint cleared staff, and 4 Youth Workers provided by the City of Berkeley. LPA walked through the facility for a health and safety check.

LPA conducted staff interviews during today's visit and will return to continue the Case Management inspection.

No deficiencies cited during today's visit.

Exit interview conducted.
A copy of the report and appeal rights provided to Director Yanci Lucero.
Notice of Site Visit provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2024
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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