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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
013423040
Report Date:
03/09/2022
Date Signed:
03/09/2022 11:02:39 AM
Document Has Been Signed on
03/09/2022 11:02 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, SUITE 1102
OAKLAND
,
CA
94612
FACILITY NAME:
YMCA EASTLAKE CENTER
FACILITY NUMBER:
013423040
ADMINISTRATOR:
MARTA PEREIRA
FACILITY TYPE:
850
ADDRESS:
1612-45TH AVE
TELEPHONE:
(510) 370-2966
CITY:
OAKLAND
STATE:
CA
ZIP CODE:
94601
CAPACITY:
60
TOTAL ENROLLED CHILDREN:
23
CENSUS:
22
DATE:
03/09/2022
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
09:07 AM
MET WITH:
Lovette Trammel
TIME COMPLETED:
11:15 AM
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Licensing Program Analysts (LPA's) Cherie Acosta and Diana Campos arrived at the facility and met with center Director Lovette Trammel for the purpose of conducting a case management inspection to correct a previous report created in error on the wrong component. On 12/10/2021 a case management inspection was conducted and a deficiency cited regarding a self reported incident that occurred on the preschool component license #013423040. LPA created the report on the infant component license # 013423039 in error. An amended report is being left with center Director and the corrected report is being created today to reflect the visit conducted on 12/10/2021.
No deficiencies cited today.
Notice of Site Visit was provided and must remain posted for 30 days. Exit interview conducted with center Director Lovette Trammel.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Diana Campos
LICENSING EVALUATOR SIGNATURE
:
DATE:
03/09/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/09/2022
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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