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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406660
Report Date: 12/29/2022
Date Signed: 12/29/2022 03:11:55 PM

Document Has Been Signed on 12/29/2022 03:11 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:YMCA CHILDCARE- VALHALLAFACILITY NUMBER:
073406660
ADMINISTRATOR:KALIE MARSHFACILITY TYPE:
840
ADDRESS:530 KIKI DRTELEPHONE:
(925) 674-1676
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 16DATE:
12/29/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Vicki Coster and Dominque ShortsTIME COMPLETED:
03:15 PM
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On 12/29/22, Licensing Program Analysts (LPAs) Melissa Domantay and Melissa Guirit conducted a case management inspection at this facility. LPAs met with Vicki Coster, Regional Childcare Director and Dominque Shorts, Site Director. There were 16 children present. An application was received with a request to add a room to the license, Room F-4. The facility will operate Monday-Friday 7:00am-6:00pm on the grounds of the Valhalla Elementary School.

A tour of the Room #F-4 was conducted for a health and safety inspection with Regional Childcare Director Vicki and Site Director Dominque Shorts. LPAs did not observe any hazardous items, defects or dangerous conditions. The entrance area of the room has a fully charged fire extinguisher and centralized combination carbon monoxide/smoke detection system. An updated superintendent's certification, indicating that Room #F-4 can be used by the child care facility was received from Regional Childcare Director Vicki Coster. A fire clearance, dated 12/28/22, was received from the Contra Costa County Fire Protection Department for a clearance of 84 school-age children, ages 4.9 years to 12 years.

Room #F-4 will be added to the school age license effective 12/29/22 with a capacity of 84 children. There are no deficiencies being cited. An exit interview was conducted with Regional Childcare Director Vicki Coster and Site Director Dominque Shorts appeal rights were provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE: DATE: 12/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/29/2022
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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