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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
073404398
Report Date:
06/03/2022
Date Signed:
06/03/2022 12:17:17 PM
Document Has Been Signed on
06/03/2022 12:17 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:
WEE CARE CENTER
FACILITY NUMBER:
073404398
ADMINISTRATOR:
ADRIENNE LOUGH
FACILITY TYPE:
850
ADDRESS:
1275 FAIRVIEW AVENUE
TELEPHONE:
(925) 634-5180
CITY:
BRENTWOOD
STATE:
CA
ZIP CODE:
94513
CAPACITY:
130
TOTAL ENROLLED CHILDREN:
100
CENSUS:
52
DATE:
06/03/2022
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME BEGAN:
09:45 AM
MET WITH:
CARRIE URIBE
TIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Cherie Acosta conducted a case management inspection to following up on a self reported incident.
It was reported that a child in care was diagnosed with having a nurse maid's elbow. There was no incident witnessed at the facility. It is unknown how or where the incident occurred.
There are no citations issued today in regard to the incident.
Report reviewed with Carrie Uribe
Notice of Site Visit was posted and must be posted for 30 day.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Cherie Acosta
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/03/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/03/2022
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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