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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408207
Report Date: 10/26/2022
Date Signed: 10/26/2022 05:03:54 PM

Document Has Been Signed on 10/26/2022 05:03 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:
073408207
ADMINISTRATOR:MUAZZAMA(AFRIN) QURASHYFACILITY TYPE:
840
ADDRESS:5521 LONE TREE WAY STE. 100TELEPHONE:
(925) 308-7693
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 10DATE:
10/26/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Lita Reeves and Muazzama(Afrin) QurashyTIME COMPLETED:
05:05 PM
NARRATIVE
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On October 26, 2022 at 9:20am Licensing Program Analysts (LPAs) Cherie Acosta and Indira Loza met with Licensee Lita Reeves and Director Muazzama Qurashy (Afrin). There were 14 School-Aged children and one fingerprint cleared staff.

LPAs observed the school-aged classroom was very dark with a single small lamp for illumination. Based on interviews, LPAs determined that the lights being shut off was making it difficult for children to see; making the environment uncomfortable for the children in care. This violates the California Code of Regulation 101223(a)(2), which is a Type B citation.

See 809-D for the Type B deficiency.

Exit interview conducted. Report and appeal rights provided to Director Afrin Qurashy.
Notice of Site visit must remain posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2022
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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Document Has Been Signed on 10/26/2022 05:03 PM - It Cannot Be Edited


Created By: Indira Loza On 10/26/2022 at 03:57 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: 073408207

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
11/23/2022
Section Cited
CCR
101223(a)(2)

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Personal Rights (2): To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement has not been met as evidenced by: Based on observation and interviews it has been determined that the children do not have sufficient lighting. This poses a potential health and safety
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There should be sufficient lighting to provide a comfortable environment for children. Director shall submit a statement decribing how this will be implemented no later than November 23, 2022.
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risk to the children in care.
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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:Mayla Mendoza
LICENSING EVALUATOR NAME:Indira Loza
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022


LIC809 (FAS) - (06/04)
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