<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
010206158
Report Date:
12/08/2021
Date Signed:
12/08/2021 02:55:14 PM
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:
BOOTH MEMORIAL DAY CARE
FACILITY NUMBER:
010206158
ADMINISTRATOR:
CRAWFORD, BRIDGETT
FACILITY TYPE:
850
ADDRESS:
2794 GARDEN STREET
TELEPHONE:
(510) 535-5088
CITY:
OAKLAND
STATE:
CA
ZIP CODE:
94601
CAPACITY:
60
CENSUS:
32
DATE:
12/08/2021
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
01:40 PM
MET WITH:
Bridgett Crawford
TIME COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/08/2021 at 1:35pm Licensing Program Analyst (LPA) Diana Campos arrived at the facility to conduct a Case Management Inspection for the purpose of obtaining a copy of the video surveillance footage regarding an incident that occurred on 11/15/2021 and reported by Center Director Bridgett Crawford. LPA met with Center Director Bridgett Crawford. Ms. Crawford arranged for the building adjacent to the center (which is part of the same property) to share the footage from their cameras as they provide a much better angle of the area in which the incident occurred.
Ms. Crawford indicated she will reach out to the security service company for information on how to create a copy of the video surveillance footage. LPA obtained a copy of video with cell phone.
No deficiencies cited during today's inspection.
This report shall remain on file for 3 years.
Exit interview conducted with Center Director Bridgett Crawford. Notice of Site Visit was provided and must remain posted for 30 days.
SUPERVISOR'S NAME:
Sherelle Johnson
TELEPHONE:
(510) 622-2592
LICENSING EVALUATOR NAME:
Diana Campos
TELEPHONE:
(510) 873-6322
LICENSING EVALUATOR SIGNATURE:
DATE:
12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
12/08/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
1