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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013410074
Report Date: 05/07/2024
Date Signed: 05/07/2024 12:45:16 PM

Document Has Been Signed on 05/07/2024 12:45 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:ECOLE BILINGUE DE BERKELEY PRESCHOOLFACILITY NUMBER:
013410074
ADMINISTRATOR/
DIRECTOR:		BURNETT, CHAUNCEYFACILITY TYPE:
850
ADDRESS:2830 TENTH ST.TELEPHONE:
(510) 549-3867
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY: 100TOTAL ENROLLED CHILDREN: 82CENSUS: 68DATE:
05/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Chauncey BurnettTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On May 7, 2024 at 9:15am, Licensing Program Analyst (LPA) Indira Loza and Licensing Program Mangaer (LPM) Mayla Mendoza met with Director Chauncey Burnett. The purpose of the visit was due to a self reported incident that was received in the Oakland Regional office on 3/27/24.

The Investigations Bureau conducted an investigation.
No deficiencies were cited during today's visit.

Exit interview conducted.
A copy of the report and appeal rights provided to Director Chauncey Burnett.
Notice of Site Visit provided and must remain posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/07/2024
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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