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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407423
Report Date: 08/25/2021
Date Signed: 08/25/2021 02:36:32 PM

Document Has Been Signed on 08/25/2021 02:36 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:BABY YALE ACADEMYFACILITY NUMBER:
073407423
ADMINISTRATOR:DEEANNA GRANATAFACILITY TYPE:
850
ADDRESS:5521 LONE TREE WAY STE100TELEPHONE:
(925) 308-7693
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY: 74TOTAL ENROLLED CHILDREN: 0CENSUS: 13DATE:
08/25/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:DeeAnna GranataTIME COMPLETED:
02:40 PM
NARRATIVE
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Licensing Program Analyst (LPA) Cherie Acosta and Diana Campos conducted an unannounced case management inspection. LPAs met with director DeeAnna Granata. There were 18 children present during the inspection.

During the inspection LPA reviewed ffour children's files. Three of the four files reviewed did not have the Acknowledgement of Receipt of Licensing Reports as required. A Non Compliance Conference was held on 12/7/20. Facility is required to provide copies of non compliance conference report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the 12 months period following the non compliance conference. All parents/guardians must sign an acknowledgement form of proof of receiving the report (LIC 9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.

See 809-D for deficiency cited during today's inspection.
Exit interview was conducted with DeeAnna Granata.
Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2021
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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Document Has Been Signed on 08/25/2021 02:36 PM - It Cannot Be Edited


Created By: Cherie Acosta On 08/25/2021 at 01:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BABY YALE ACADEMY
FACILITY NUMBER: 073407423

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/08/2021
Section Cited
HSC
1596.8595(d)(3)

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Posting licensing report by child care facility or home; duration of posting; civil penalty for failure to comply; reports to be provided to parents or guardian of each child receiving services . The licensee shall require each recipient of the licensing document pertaining to
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Director shall ensure all parents are provided a copy of the non compliance conference report dated 12/7/20 and ensure the signed LIC9224 is in each enrolled child's file and newly enrolled children's file.
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a conference to sign a statement indicating that he or she has received the document and the date it was received. This requirement was not met as evidenced by 3 of 4 files reviewed did not have LIC9224 on file which poses a potential risk to the children in care
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Director shall submit a letter to CCL by 9/8/21 ensuring this is done.
Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Sherelle Johnson
LICENSING EVALUATOR NAME:Cherie Acosta
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2021


LIC809 (FAS) - (06/04)
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