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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
073408866
Report Date:
10/26/2023
Date Signed:
10/26/2023 04:19:33 PM
Document Has Been Signed on
10/26/2023 04:19 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 ACADEMY
FACILITY NUMBER:
073408866
ADMINISTRATOR:
GRICELDA MITCHELL
FACILITY TYPE:
840
ADDRESS:
1620 NERLOY RD.
TELEPHONE:
(925) 261-6717
CITY:
OAKLEY
STATE:
CA
ZIP CODE:
94561
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
15
CENSUS:
0
DATE:
10/26/2023
TYPE OF VISIT:
POC
UNANNOUNCED
TIME BEGAN:
09:00 AM
MET WITH:
Assistant Director Ayisha Lopes later with Director Noelle Mills
TIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced Plan of Correction (POC) visit. LPA met with Assistant Director Ayisha Lopes later with Director Noelle Mills
The facility was cited on 9/21/23 for not providing sufficient supervision to children in care which resulted in children engaging in an inappropriate activity.
Director provided a plan of action to ensure children have sufficient supervision at all time. Staff received training on supervision on 11/19/23. The facility has also purchased additional outside activities for the children. The citation issued on 9/21/23 is cleared today.
Exit interview and report reviewed with owners Vijay and Rishu Khare.
Notice of Site visit was provided and must be posted for 30 days.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Cherie Acosta
LICENSING EVALUATOR SIGNATURE
:
DATE:
10/26/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/26/2023
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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