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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
073408277
Report Date:
06/08/2021
Date Signed:
06/08/2021 03:38:00 PM
Document Has Been Signed on
06/08/2021 03:38 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 ACADEMY-HARVEST PARK
FACILITY NUMBER:
073408277
ADMINISTRATOR:
CHI, REBECCA
FACILITY TYPE:
850
ADDRESS:
605 HARVEST PARK, STE A
TELEPHONE:
(925) 626-5004
CITY:
BRENTWOOD
STATE:
CA
ZIP CODE:
94513
CAPACITY:
22
TOTAL ENROLLED CHILDREN:
0
CENSUS:
8
DATE:
06/08/2021
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
02:30 PM
MET WITH:
Nicole Moran-Estrada
TIME COMPLETED:
04:45 PM
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Licensing Program Analysts Diana Campos and Cherie Acosta conducted an unannounced case management inspection. The purpose of today's case management inspection was to follow up on the director's package submitted for Nicole Moran-Estrada. Nicole has been the acting director of this site since October 2020. An incomplete directors package was received by Community Care Licensing on 3/29/21. The following documents are required to complete the director's package:
- Proof of current EMSA approved CPR/First aid
- Proof of Lead Poisoning Prevention training
The director agrees to submit the above documents by 07/01/2021
Exit interview was conducted with Director Nicole Moran-Estrada and Lita Reeves.
Appeal Rights were provided. 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:
06/08/2021
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/08/2021
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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