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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407437
Report Date: 09/11/2024
Date Signed: 09/11/2024 11:15:19 AM

Document Has Been Signed on 09/11/2024 11:15 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:PATTY'S MONTESSORI SCHOOLFACILITY NUMBER:
073407437
ADMINISTRATOR/
DIRECTOR:		MAYBERRY, REBECCAFACILITY TYPE:
850
ADDRESS:801 PARK CENTRAL STTELEPHONE:
(510) 223-0314
CITY:RICHMONDSTATE: CAZIP CODE:
94803
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 16DATE:
09/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:RUCOBO, MARIA TIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On September 11, 2024 at 9:00AM Licensing Program Analyst (LPA) Nyeesha Blount conducted an unannounced case management visit in regards to an incident that was reported to our Regional Office on August 26, 2024. LPA met with Director Rucobo, Maria present during the inspection were (3) staff members, (16) preschool children. An incident occurred in the facility where a child injured his right foot.


No Deficiencies were sited during today's visit. Exit interview was conducted.
Report was reviewed and a copy was provided to Director Maria Rucobo along with appeal rights and Notice of Site Visit was given.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE: DATE: 09/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/11/2024
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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