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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070207368
Report Date: 02/05/2020
Date Signed: 02/07/2020 10:04:29 AM

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:MORAGA VALLEY PRESBYTERIAN CHURCH NURTURYFACILITY NUMBER:
070207368
ADMINISTRATOR:KELLAHER, CONNIEFACILITY TYPE:
850
ADDRESS:10 MORAGA VALLEY LANETELEPHONE:
(925) 376-4800
CITY:MORAGASTATE: CAZIP CODE:
94556
CAPACITY:150CENSUS: 52DATE:
02/05/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Christiane GrupeTIME COMPLETED:
02:50 PM
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LPA, Hollie, met with Assistant Director/Afternoon Coordinator, for the purpose of a Case Management visit. The Director, Ms. Connie, is not present today. There are 52 children present.
LPA conducted interviews with some staff. As to not interrupt the facility ratio, additional staff will be reviewed at a later date.

There are no deficiencies cited today.
SUPERVISOR'S NAME: Anika EvansTELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Ronda HollieTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020
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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