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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010213003
Report Date: 04/07/2023
Date Signed: 04/07/2023 03:28:09 PM


Document Has Been Signed on 04/07/2023 03:28 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:ALAMEDA ISLAND KIDS AT EDISON SCHOOLFACILITY NUMBER:
010213003
ADMINISTRATOR:NAVARRO, CHRISTINEFACILITY TYPE:
840
ADDRESS:2700 BUENA VISTA AVE.TELEPHONE:
(510) 769-1975
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:98CENSUS: DATE:
04/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Angela SmithTIME COMPLETED:
03:30 PM
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On 4/7/2023 at 2:49pm, Licensing Program Analyst (LPA) Catherine Fernandes met with Director Angela Smith for an Unannounced Required Annual Inspection. During the inspection the center had was having an Easter celebration with the children in care. Due to time restraints the inspection will continue on another date.

Exit interview conducted

Report and Appeal Rights provided

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2023
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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