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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409651
Report Date: 09/13/2024
Date Signed: 09/13/2024 01:26:26 PM

Document Has Been Signed on 09/13/2024 01:26 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:MACWILLIAMS, VIRGINIAFACILITY NUMBER:
434409651
ADMINISTRATOR/
DIRECTOR:		MACWILLIAMS, VIRGINIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 961-8577
CITY:MOUNTAIN VIEWSTATE: CAZIP CODE:
94041
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 8DATE:
09/13/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Virginia MacWilliamsTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On 09/13/2024 at 11:45am, Licensing Program Analyst (LPA) Christina Uribe met with licensee Virginia MacWilliams for the purpose of an unannounced Case Management Visit - Incident visit. The licensee is within ratio today with 8 children (4 infants & 4 older children) present at the time of the inspection. Also present at the time of today's inspection is fingerprint cleared assistant Nicole Cadenas. At around 12:00pm, Licensee's fingerprint cleared adult relative/resident of the home, Katrina Palado, arrived.

On 08/23/2024, Licensee reported an unusual incident to CCLD Child Care Program Oakland Regional Office via phone. During today's visit, LPA Uribe conducted and documented interviews regarding the nature and details of the unusual incident that the licensee reported on 08/23/24.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the licensee, Virginia MacWilliams.

Page 1 of 1 ***End of Report***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2024
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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