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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423679
Report Date: 03/07/2023
Date Signed: 03/07/2023 02:32:54 PM

Document Has Been Signed on 03/07/2023 02:32 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:SANTANA, GERALDOFACILITY NUMBER:
013423679
ADMINISTRATOR:SANTANA, GERALDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 527-1652
CITY:BERKELEYSTATE: CAZIP CODE:
94702
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/07/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Geraldo SantanaTIME COMPLETED:
02:42 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 March 7, 2023 at 10:55 am Licensing Program Analyst (LPA) met with Licensee Geraldo Santana to conduct an unannounced Plan of Correction inspection. Present for the inspection were four infants and the Licensee.

During an unannounced complaint investigation conducted on February 16, 2023 the LPA observed seven infants in care, violating the California Code of Regulation 102416.5(d)(1), which is a Type A citation. The deficiency was cleared during today's inspection as there were only four infants in care and the Licensee submitted the required documents. A clearance letter was provided.

.
No further citations were issued today. This report was reviewed with Licensee Geraldo Santana.
Report and appeal rights were provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2023
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