<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
073408285
Report Date:
09/07/2021
Date Signed:
09/07/2021 10:49:07 AM
Document Has Been Signed on
09/07/2021 10:49 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:
KIDDIE ACADEMY
FACILITY NUMBER:
073408285
ADMINISTRATOR:
AUTUMN BROOKS
FACILITY TYPE:
850
ADDRESS:
8680 BRENTWOOD BLVD.
TELEPHONE:
(925) 683-3369
CITY:
BRENTWOOD
STATE:
CA
ZIP CODE:
94513
CAPACITY:
120
TOTAL ENROLLED CHILDREN:
0
CENSUS:
DATE:
09/07/2021
TYPE OF VISIT:
Office
UNANNOUNCED
TIME BEGAN:
10:00 AM
MET WITH:
Autumn Brooks
TIME COMPLETED:
10:30 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
Licensing Program Manager (LPM) Sherelle Johnson and Licensing Program Analyst (LPA) Cherie Acosta met with Director Autumn Brooks and Regional Director Shaina Blake by use of Microsoft Teams to conduct an informal meeting. An in person meeting was not conducted due to the COVID-19 pandemic.
The purpose of the meeting is to discuss an incident that occurred on 07/29/2021 where a child was left unattended for approximately two minutes during transition. Director self reported the incident.
The director submitted a written plan of action by email on 8/6/21. The director stated that transitions are now supervised by the management teams. Staff training was held on 8/24/21. Staff are now doing a name to face recognition during transitions and logging the name to face recognition on the Tadpole App.
Director stated she will submit a copy of the meeting agenda from staff training held on 08/24/21.
Facility will have more frequent visits to ensure supervision is being maintained.
Director is reminded that compliance is extremely important. Subsequent care and supervision violations may result in possible administrative action.
Exit interview was conducted with Director and Regional Director.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Cherie Acosta
LICENSING EVALUATOR SIGNATURE
:
DATE:
09/07/2021
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
09/07/2021
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