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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201491
Report Date: 03/20/2025
Date Signed: 03/20/2025 12:10:11 PM

Document Has Been Signed on 03/20/2025 12:10 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, STE. 310
OAKLAND, CA 94612
FACILITY NAME:STERLING ESTATES CONCORD LLCFACILITY NUMBER:
079201491
ADMINISTRATOR/
DIRECTOR:		SERGEY, VALERIEFACILITY TYPE:
740
ADDRESS:2930 LANE DRIVETELEPHONE:
(925) 808-9778
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY: 6CENSUS: 0DATE:
03/20/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Sterling Jones, Licensee TIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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LPA conducted Component III with Licensee, Administrator during visit. LPA presented Component III Power Point and discussed the regulations embodied in the presentation.

No issues noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Centralized Application Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required.

Exit interview conducted and a copy of this report will be emailed.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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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