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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422003
Report Date: 12/17/2024
Date Signed: 12/17/2024 03:46:54 PM

Document Has Been Signed on 12/17/2024 03:46 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 - UNITED NATION CHILD DEVELOPMENT CENTERFACILITY NUMBER:
013422003
ADMINISTRATOR/
DIRECTOR:		MANSKER, ANNAFACILITY TYPE:
850
ADDRESS:1025 - 4TH AVETELEPHONE:
(510) 273-1616
CITY:OAKLANDSTATE: CAZIP CODE:
94606
CAPACITY: 168TOTAL ENROLLED CHILDREN: 168CENSUS: DATE:
12/17/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:35 PM
MET WITH:Mirsha HerediaTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On December 17, 2024, Licensing Program Analyst (LPA) Indira Loza conducted an unannounced case management visit regarding an unusual incident reported to the Oakland Regional Office on November 22, 2024. The LPA met with Site Supervisor Mirsha Heredia.

LPA toured the center for a Health and Safety check and interviewed the Site Supervisor about the incident that occurred. LPA will return to continue the case management.

No deficiencies cited during today's visit. Exit interview conducted.

A copy of the report and appeal rights provided to Site Supervisor Mirsha Heredia.
Notice of Site Visit provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2024
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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