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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201343
Report Date: 03/22/2024
Date Signed: 03/22/2024 02:43:49 PM

Document Has Been Signed on 03/22/2024 02:43 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:REE FACILITY LLCFACILITY NUMBER:
079201343
ADMINISTRATOR:ALCANTARA, AILEENETHFACILITY TYPE:
735
ADDRESS:1152 SHADOWCLIFF WAYTELEPHONE:
(925) 505-8533
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY: 4CENSUS: 0DATE:
03/22/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Applicant Aileeneth AlcantaraTIME COMPLETED:
03:00 PM
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On 3/22/2024 at 12:45 PM, Licensing Program Analyst (LPA) J. Sampair arrived to conduct an announced prelicensing inspection. Upon arrival, the LPA identified himself and confirmed the purpose of the meeting with Applicant Aileeneth Alcantara.

The LPA and Applicant toured the interior and exterior of the facility and reviewed necessary documentation. The LPA and Applicant completed the COMP III training.

Pre-Licensing is complete.

Exit interview conducted and a copy of this report was provided via email to Applicant.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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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