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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409598
Report Date: 08/07/2024
Date Signed: 08/07/2024 04:09:58 PM

Document Has Been Signed on 08/07/2024 04:09 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:YMCA OF THE EAST BAY -LONE TREE ELCFACILITY NUMBER:
073409598
ADMINISTRATOR/
DIRECTOR:		SHAMAICA WALKERFACILITY TYPE:
860
ADDRESS:1931 MOKELUMNE DRIVETELEPHONE:
(925) 450-6954
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 14DATE:
08/07/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Anita RetzingerTIME VISIT/
INSPECTION COMPLETED:
09:45 AM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Alecia Sifuentes met with Director of Fiscal Services Anita Retzinger for the purpose of a second pre-licensing inspection. Licensee is requesting to add a toddler component for 8 toddlers ages 18-36 months and a decrease in capacity for the currently licensed preschool component for 37 children from age two years to entry into kindergarten for a total capacity of 45. The program currently operates Monday through Friday from 7:00 a.m. to 5:30 p.m. The amended fire clearance was granted and received on 7/22/2024.

LPA informed Director that the facility will be converted to a single child care center license under facility number 073409598, therefore LPA will be closing the current preschool facility number 073408944.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property. Licensee previously requested a Shared Outdoor Space Waiver for the toddlers and preschool children to utilize the preschool outdoor activity space at different designated times due to the toddler component not having their own separate outdoor area. LPA informed Director that since the overall outdoor activity space can accommodate Licensee’s total requested capacity of 45, a Shared Outdoor Space Waiver is not needed.

Director has designated an area for the toddler component which is located on the blacktop area. Director has separated the outdoor space using temporary fence barriers. LPA measured the designated toddler space. The space contains a total of 630 square feet which will accommodate Licensee’s request for 8 toddlers.

Report continues on LIC809-C.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: YMCA OF THE EAST BAY -LONE TREE ELC
FACILITY NUMBER: 073409598
VISIT DATE: 08/07/2024
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Director has designated an area for the preschool component which is located on the play structure area. LPA measured the designated preschool space. The space contains a total of 2,779 square feet which will accommodate Licensee’s request for 37 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). There are shaded areas supplied by trees and a canopy.

Effective today, 8/7/2024, LPA will approve the change of components served and change in capacity for 8 toddlers ages 18-36 months in classroom #1A and 37 preschool children ages two years to entry into kindergarten in classrooms #1B and #2.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Alecia Sifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
LIC809 (FAS) - (06/04)
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