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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013411745
Report Date: 01/22/2025
Date Signed: 01/22/2025 04:03:24 PM

Document Has Been Signed on 01/22/2025 04:03 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 1102
OAKLAND, CA 94612
FACILITY NAME:CHABOT COLLEGE, CHILDREN'S CENTERFACILITY NUMBER:
013411745
ADMINISTRATOR/
DIRECTOR:		SAN JOSE, NANCYFACILITY TYPE:
850
ADDRESS:25555 HESPERIAN BOULEVARDTELEPHONE:
(510) 723-6684
CITY:HAYWARDSTATE: CAZIP CODE:
94545
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 0DATE:
01/22/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:27 PM
MET WITH:Michelle McGregorTIME VISIT/
INSPECTION COMPLETED:
04:02 PM
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On 1/22/2025 Licensing Program Analyst (LPA) Morgan Pringle conducted a case management visit for an incident that occurred on 10/16/2024. Present during the inspection were four (4) staff members. No children were present during the visit.

On 10/16/2024 an incident was self reported by the facility stating a grandparent came to pick up a child from the facility who was not listed as an authorized representative. Facility staff stated the child is a younger sibling of a child that was previously enrolled in care and the grandparent was listed as an authorized representative for the older sibling. Staff stated that the parent was immediately called to verify that the grandparent was supposed to pick the child up for the day and the parent confirmed that to be true. Staff informed the parent that the grandparent needed to be placed as someone who is allowed to pick up the child on the child's emergency form. The child's parent made the correction the next day the child was in care.

No deficiencies were cited during LPA's visit.

A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted with facility staff Michelle McGregor.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
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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