<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423537
Report Date: 08/06/2024
Date Signed: 08/06/2024 10:04:45 AM

Document Has Been Signed on 08/06/2024 10:04 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:BEY, KAAMILFACILITY NUMBER:
013423537
ADMINISTRATOR/
DIRECTOR:
BEY, KAAMILFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 290-8344
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
08/06/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Blanca GomezTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA D. Campos arrived at the facility and met with fingerprint cleared assistant Blanca Gomez for the purpose of conducting a Case Management inspection to deliver an amended report. Licensee was present at facility but indisposed. Present during this visit were 9 children in care consisting of 7 toddlers and 2 infants and 3 fingerprint cleared assistants.
Please see the amended report LIC809 and LIC809C for corrections made.

No citations issued as a result of this visit.

Exit interview conducted and report reviewed with assistant Blanca Gomez.
Notice of Site Visit provided and must remain posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1