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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422484
Report Date: 06/16/2022
Date Signed: 06/16/2022 04:17:29 PM

Document Has Been Signed on 06/16/2022 04:17 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:UNITY COUNCIL CHILD CENTERFACILITY NUMBER:
013422484
ADMINISTRATOR:ELIZABETH CROCKERFACILITY TYPE:
830
ADDRESS:2615 E 15TH STTELEPHONE:
(510) 535-2760
CITY:OAKLANDSTATE: CAZIP CODE:
94601
CAPACITY: 30TOTAL ENROLLED CHILDREN: 22CENSUS: 3DATE:
06/16/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:LaRichea SmithTIME COMPLETED:
04:20 PM
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Licensing Program Analyst Diana Campos met with Center Director LaRichea Smith for the purpose of conducting an UNANNOUNCED CASE MANAGEMENT INSPECTION as a result from receiving a self reported unusual incident. Present for this inspection were 5 staff members and 3 infants. Interview with center Director was conducted. Staff interviews were conducted, Facility Rosters and Personnel Report were obtained

Based on the information provided at this time, there were no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with Center Director LaRichea Smith.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2022
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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