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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408905
Report Date: 11/15/2021
Date Signed: 11/15/2021 04:15:31 PM

Document Has Been Signed on 11/15/2021 04:15 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:CONTRA COSTA CO. CDC-CRESCENT PARKFACILITY NUMBER:
073408905
ADMINISTRATOR:FRAZIER-STAFFORD, LINDAFACILITY TYPE:
830
ADDRESS:5050 HARTNET AVENUETELEPHONE:
(510) 374-3701
CITY:RICHMONDSTATE: CAZIP CODE:
94804
CAPACITY: 17TOTAL ENROLLED CHILDREN: 17CENSUS: 1DATE:
11/15/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Michelle FreemanTIME COMPLETED:
04:30 PM
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On November 15, 2021 Licensing Program Analyst (LPA) Caroline Colson met with Michelle Freeman, Center Director for an unannounced case management inspection at 12:41 PM. There is one (1) infant and three staff members including the center director present. Documentation was obtained. Interviews were conducted. The purpose of the inspection was the result of receiving an unusual incident report.

There were no deficiencies cited. Appeal Rights were given. A site visit notice was posted.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2021
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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