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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423773
Report Date: 02/26/2025
Date Signed: 02/26/2025 04:12:17 PM

Document Has Been Signed on 02/26/2025 04:12 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:YMCA OF THE EAST BAY - WEST YFACILITY NUMBER:
013423773
ADMINISTRATOR/
DIRECTOR:		CROSS-BROOKS, GLORIAFACILITY TYPE:
860
ADDRESS:2009 10TH STREETTELEPHONE:
(510) 848-9092
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY: 79TOTAL ENROLLED CHILDREN: 79CENSUS: 23DATE:
02/26/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:55 PM
MET WITH:Gloria Cross-BrooksTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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On February 26, 2025, Licensing Program Analyst (LPA) Indira Loza met with Director Gloria Cross-Brooks to conduct a case management visit regarding a self reported incident received in the Oakland Regional Office on January 15, 2025. Present during today's visit were 23 preschoolers and 10 staff.

There were no deficiencies cited during today's visit.

Exit Interview conducted.
Report and Appeal Rights provided to Director Gloria Cross-Brooks. .
Notice of Site Visit provided and must remain posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
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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