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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407425
Report Date: 10/26/2022
Date Signed: 10/26/2022 04:58:14 PM


Document Has Been Signed on 10/26/2022 04:58 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:BABY YALE ACADEMYFACILITY NUMBER:
073407425
ADMINISTRATOR:MUAZZAMA(AFRIN) QURASHYFACILITY TYPE:
830
ADDRESS:5521 LONE TREE WAYTELEPHONE:
(925) 308-7693
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:66CENSUS: 6DATE:
10/26/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Lita Reeves and Muazzama(Afrin) QurashyTIME COMPLETED:
05:00 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 October 26, 2022 at 9:20am Licensing Program Analysts (LPAs) Cherie Acosta and Indira Loza met with Licensee Lita Reeves and Director Muazzama Qurashy (Afrin). Present for the inspection were two adults and six infants.

LPAs checked the staff for fingerprint clearance and found that one of the two adults in the classroom were not fingerprint cleared. Staff 1 (S1) was removed from the facility immediately. This violates California Code of Regulations (CCR) 101170(e)(1). This is a Type A violation, and poses an immediate risk to health and safety of children in care.

One type A deficiency is being cited during todays inspection (See 809-D). The Director must provide a copy of this report to all parents of children currently enrolled, and the parents of newly enrolled children in the next 12 months. In addition, form LIC 9224 (Acknowledgment of Receipt of Licensing Reports) must be signed by each parent and placed in each child's file. A copy of the LIC 9224 is being provided to the Director during the inspection.

Exit interview conducted. Report and Appeal Rights provided to Director Afrin Qurashy.
Notice of Site visit must remain posted for 30 days
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
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 2


Document Has Been Signed on 10/26/2022 04:58 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612


FACILITY NAME: BABY YALE ACADEMY
FACILITY NUMBER: 073407425

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/27/2022
Section Cited

1
2
3
4
5
6
7
Criminal Record Clearance: 101170(e)(1) -Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met as evidenced by: An unfingerprinted staff member was caring for children, the staff has been working at the facility for approximately one month. This poses an immediate risk to the
1
2
3
4
5
6
7
Effectively immediately S1 must not be at the facility until a fingerprint clearance is received. Director shall submit a letter ensuring the individual is no longer at the facility pending fingerprint clearance. The director shall submit the statement no later than October 27, 2022.
8
9
10
11
12
13
14
 health and safety of the children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2