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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070212900
Report Date: 02/23/2023
Date Signed: 02/23/2023 01:45:15 PM


Document Has Been Signed on 02/23/2023 01:45 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:WOODBRIDGE CHILDREN'S CENTER - JOHN MUIRFACILITY NUMBER:
070212900
ADMINISTRATOR:BANY NOGUERAFACILITY TYPE:
840
ADDRESS:205 VISTA WAYTELEPHONE:
(925) 229-5767
CITY:MARTINEZSTATE: CAZIP CODE:
94553
CAPACITY:125CENSUS: DATE:
02/23/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:BANY MOGUERATIME COMPLETED:
11:17 AM
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Licensing Program Analyst Tasha Alexander met today with center director Bany Noguera to discuss a self reported unusual incident that happened on December 9th 2022 when a child in care became disruptive and began throwing legos/blocks at other children in care.

Per director, the child's parent was also notified and they are now working together to try to prevent this sort of behavior to protect other children in care.

based on today's interviews, there are no deficiencies cited today.

An exit interview was conducted.

A notice of site visit was posted.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2023
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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