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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073403024
Report Date: 09/16/2024
Date Signed: 09/16/2024 10:56:13 AM

Document Has Been Signed on 09/16/2024 10:56 AM - 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:THOMAS, YOLANDAFACILITY NUMBER:
073403024
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
09/16/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Yolanda ThomasTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Manager (LPM) Sherelle Johnson and Licensing Program Analyst (LPA) Cherie Acosta met with Yolanda Thomas for an informal meeting in regards to an incomplete application that was submitted for an increase in capacity received on 6/26/23. Also present in the meeting was Charles Allen, Representative form United Domestic Workers (UDW), and Reverend A. Wayne Johnson

During the meeting provider requested to have a more collaborative relationship between Community Care Licensing (CCL) and providers. LPM Johnson will pass this information to the Department's program office.

Today licensee provided a copy of Brian Thomas' immunization record. Licensee is now in compliance with licensing requirement. The increase in capacity to care for up to 14 children is approved as of today 9/16/24. The license will be generated and mailed to licensee 9/17/24.

Report was reviewed with Yolanda Thomas.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE: DATE: 09/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/16/2024
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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