<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418167
Report Date: 04/29/2021
Date Signed: 04/29/2021 10:15:27 AM

Document Has Been Signed on 04/29/2021 10:15 AM - 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 1102
OAKLAND, CA 94612
FACILITY NAME:CAPE - BESS PLATTFACILITY NUMBER:
013418167
ADMINISTRATOR:FERREIRA, LILIAMFACILITY TYPE:
850
ADDRESS:1401 ALMOND AVETELEPHONE:
(925) 447-8710
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/29/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Regina LopezTIME COMPLETED:
10:15 AM
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 04/29/2021 Licensing Program Analyst (LPA) Jaylena Miller conducted an unannounced case management visit and met with Interim Executive Director Regina Garcia for the purpose of obtaining copies of a former employees file and child rosters during their employment.

No deficiencies were cited during todays visit. Notice of site visit given and must be posted for 30 days. A copy of this report must be maintained for 3 years and available for public review upon request.

Exit interview conducted with Interim Executive Director, Regina Garcia.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2021
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