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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423587
Report Date: 10/13/2023
Date Signed: 10/13/2023 08:54:35 AM

Document Has Been Signed on 10/13/2023 08:54 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:ANDRADA, MIYANIFACILITY NUMBER:
013423587
ADMINISTRATOR:ANDRADA, MIYANIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 332-8806
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
10/13/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Brenda GamaTIME COMPLETED:
09:00 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
On October 13, 2023, Licensing Program Analyst (LPA) Randall Dunevant conducted an unannounced Case Management to clear Plan of Correction (POC) deficiencies for Ratio Compliance. LPA met with assistant Brenda Gama. Present during the inspection were 4 infants, 7 preschool children and one fingerprint cleared assistants. The license is operating within ratio, POC cleared by today’s visit.

Exit interview conducted with Brenda Gama, Notice of Site visit given and must remain posted for 30 days.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Randall Dunevant
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2023
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