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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408285
Report Date: 08/11/2023
Date Signed: 08/11/2023 03:41:55 PM

Document Has Been Signed on 08/11/2023 03:41 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:KIDDIE ACADEMYFACILITY NUMBER:
073408285
ADMINISTRATOR:AUTUMN BROOKSFACILITY TYPE:
850
ADDRESS:8680 BRENTWOOD BLVD.TELEPHONE:
(925) 683-3369
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY: 120TOTAL ENROLLED CHILDREN: 62CENSUS: 31DATE:
08/11/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Autumn BrooksTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Cherie Acosta conducted an a Plan of Correction (POC) visit. LPA met with Director Autumn Brooks.

The facility was cited on 8/8/23 for failure to notify children's authorized representatives of Type A citations issued on 8/4/22, 5/5/23 and 6/28/23. During today's inspection the facility has copies of signed Acknowledgement of Receipt of Licensing Reports (LIC9224) for citations issued 8/4/22, 5/5/23 and 6/28/23.

Citation issued on 8/8/23 is cleared today.

Notice of Site Visit was provided and must be posted for 30 days.
Exit interview and report reviewed with Autumn Brooks
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2023
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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