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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423745
Report Date: 08/16/2023
Date Signed: 08/16/2023 04:23:15 PM

Document Has Been Signed on 08/16/2023 04:23 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:SHU REN INTERNATIONAL SCHOOLFACILITY NUMBER:
013423745
ADMINISTRATOR:YI QUEFACILITY TYPE:
850
ADDRESS:1422 SAN PABLO AVENUETELEPHONE:
(408) 508-6259
CITY:BERKELEYSTATE: CAZIP CODE:
94702
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 0DATE:
08/16/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Charles MillerTIME COMPLETED:
04:00 PM
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On 08/16/23 Licensing Program Analyst (LPA) Melissa Domantay arrived at the facility for an announced pending pre-licensing inspection for a preschool license. LPA met with the Applicant, Charles Miller and Kurtis Pierce. An application for a preschool license was received for this facility. The facility will operate Monday-Friday 7:30AM to 6:00PM. The preschool has 4 classrooms and one outdoor playground for children to utilize.

LPA toured the outdoor playground area and observed turf was completely set up as cushion to absorb a child's fall and the play structure was completely set up for children to utilize. Per Applicant, Charles Miller, shading for outdoor playground has been ordered and should arrive before facility begins operating, 8/28/2023. LPA notified Applicant, Charles to provide photos of shading to LPA to ensure shading has been set up for children in the outdoor playground.

A preschool license for a capacity of 74 children will be made part of the Preschool License with a total capacity of 74 is approved as of 8/16/2023. There are no deficiencies being cited today. Exit interview conducted with Applicant, Charles Miller and Kurtis Pierce.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2023
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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