<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
079201397
Report Date:
12/04/2024
Date Signed:
12/04/2024 12:40:29 PM
Document Has Been Signed on
12/04/2024 12:40 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:
A STEP ABOVE, LLC
FACILITY NUMBER:
079201397
ADMINISTRATOR/
DIRECTOR:
JOHNSON, JOHN PAUL
FACILITY TYPE:
775
ADDRESS:
161 SAND CREEK ROAD
TELEPHONE:
(925) 481-2189
CITY:
BRENTWOOD
STATE:
CA
ZIP CODE:
94513
CAPACITY:
70
CENSUS:
0
DATE:
12/04/2024
TYPE OF VISIT:
Case Management - Other
ANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:
Merfe Bailey, Program Director
TIME VISIT/
INSPECTION COMPLETED:
12:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/04/2024 at 12:21PM Licensing Program Analyst (LPA) T.Syess-Gibson conducted an announced pre-licensing inspection with a Comp III and met with Merfe Bailey- Program Director.
Comp III was waived per Licensing Program Manager (LPM) H. Humpal.
Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME
:
Harpreet Humpal
LICENSING EVALUATOR NAME
:
Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE
:
DATE:
12/04/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
12/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
1