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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010215033
Report Date: 02/23/2024
Date Signed: 02/23/2024 01:35:40 PM

Document Has Been Signed on 02/23/2024 01:35 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:OAKLAND HEAD START - MANZANITAFACILITY NUMBER:
010215033
ADMINISTRATOR:TERRY CHENFACILITY TYPE:
850
ADDRESS:2701 - 22ND AVENUETELEPHONE:
(510) 535-5627
CITY:OAKLANDSTATE: CAZIP CODE:
94606
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 12DATE:
02/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:TERRY CHENTIME COMPLETED:
01:45 PM
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On February 23, 2024 Licensing Program Analyst Tasha Alexander met with Center director Terry Chen to discuss a self reported Unusual incident that occurred when a child told their parent that they did not want to go to school that day because their teacher was "mean to them".

Today an interview was conducted with the center director. Per director, a meeting was held with the child's parent, teacher, family advocate, the education manager, and the family services specialist. LPA also spoke with the child's parent.

Based on record reviews, conversations, and interviews, no deficiencies are cited today.


An exit interview was conducted. A notice of site visit was posted.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2024
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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