<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201414
Report Date: 11/07/2024
Date Signed: 11/07/2024 01:53:03 PM

Document Has Been Signed on 11/07/2024 01:53 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:LIGHT OF GRACE IFACILITY NUMBER:
079201414
ADMINISTRATOR/
DIRECTOR:		ABDULLAH-GRAYSON, TARRAFACILITY TYPE:
740
ADDRESS:34 MORNING GLORY CT.TELEPHONE:
(925) 303-5503
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY: 6CENSUS: 0DATE:
11/07/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:35 PM
MET WITH:Tarra Abdullah-Grayson, AdminsitratorTIME VISIT/
INSPECTION COMPLETED:
02:03 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 11/07/2024 An announced Pre-licensing Comp III associated with Pre-Licensing Inspection done on 11/07/2024 at 12:35PM was conducted by Licensing Program Analyst (LPA) T. Syess-Gibson. Comp III was attended by Tarra Abadullah-Grayson, Administrator/Licensee.

LPA concluded Comp III.


No citation made during this visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2024
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