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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200873
Report Date: 01/15/2025
Date Signed: 01/15/2025 05:00:23 PM

Document Has Been Signed on 01/15/2025 05:00 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:POINT AT ROCKRIDGE, THEFACILITY NUMBER:
019200873
ADMINISTRATOR/
DIRECTOR:		JEFF SUMABATFACILITY TYPE:
740
ADDRESS:4500 GILBERT STREETTELEPHONE:
(510) 658-9266
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY: 186TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
01/15/2025
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:15 PM
MET WITH:Executive Director Becca BlackTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
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On 1/15/2025 at approximately 4:15 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced at the facility for this collateral visit to have an Amended copy of the LIC 9099 and LIC 9099-C from Complaint 15-AS-20241106155241 signed by a member of the management team. Upon entry into the facility, the LPA stated the purpose of the visit to Executive Director (ED) Becca Black.

The LPA reviewed the LIC 9099 and LIC 9099-C with the ED, after which the ED signed the amended documents.

Exit interview conducted and a copy of this report was provided.
Harpreet HumpalTELEPHONE: (510) 529-9416
James SampairTELEPHONE: (510) 286-4201
DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/15/2025
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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