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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010216579
Report Date: 11/28/2022
Date Signed: 11/28/2022 03:20:23 PM

Document Has Been Signed on 11/28/2022 03:20 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:OUSD - HOWARD SCHOOLFACILITY NUMBER:
010216579
ADMINISTRATOR:HANNAH, RICKIEFACILITY TYPE:
850
ADDRESS:8755 FONTAINE STREETTELEPHONE:
(510) 639-3262
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 11DATE:
11/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:47 PM
MET WITH:Dr. Lottie LynchTIME COMPLETED:
03:35 PM
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LPA Lisa Dyer met with Dr. Lottie Lynch for a case management inspection as a result of receiving an unusual incident report. The director, an aid, and 11 preschoolers were present.

As a result of this visit, there are no deficiencies cited.

A site visit notice was posted.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2022
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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