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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420552
Report Date: 03/25/2024
Date Signed: 03/25/2024 09:47:23 AM

Document Has Been Signed on 03/25/2024 09:47 AM - 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:OUSD - PRESCOTT PRESCHOOLFACILITY NUMBER:
013420552
ADMINISTRATOR:FORD, IANTHAFACILITY TYPE:
850
ADDRESS:920 CAMPBELL STTELEPHONE:
(510) 874-3333
CITY:OAKLANDSTATE: CAZIP CODE:
94607
CAPACITY: 24TOTAL ENROLLED CHILDREN: 16CENSUS: 13DATE:
03/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lien Tu TIME COMPLETED:
10:00 AM
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On 03/25/2024 at 9:00 AM Licensing Program Analyst (LPA), A. Curry conducted an unannounced case management inspection follow up on deficiencies that were previously cited on 02/14/2024. LPA met with the Lead Teacher, Lien Tu, to explain the purpose of today's visit. LPA toured the facility and reviewed staff files. No deficiencies are being cited today.



Exit interview conducted, appeal rights were given, and report was reviewed with the Lead Teacher, LIen Tu.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2024
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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