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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010215251
Report Date: 09/27/2023
Date Signed: 09/27/2023 12:08:31 PM


Document Has Been Signed on 09/27/2023 12:08 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:EDWARDS-ROBINSON, SHONTAFACILITY NUMBER:
010215251
ADMINISTRATOR:EDWARDS-ROBINSON, SHONTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 640-6349
CITY:OAKLANDSTATE: CAZIP CODE:
94603
CAPACITY:14CENSUS: 8DATE:
09/27/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Shonta Edwards-RobinsonTIME COMPLETED:
12:30 PM
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On 09/27/2023 at 11:45 AM, Licensing Program Analysts (LPA) Christina Watts and Ashley Akinleye conducted a Case Management Inspection for Shonta Edwards-Robinson's large family home. During today's inspection, there was 8 children in care (3 infants and 5 preschool aged children) with an assistant. Licensee stated there are 15 children enrolled. All persons present and caring for children have Criminal Record Clearance.

LPAs are following up on 2 citations given to the facility on 09/06/2023 for Ratio and Capacity as well as expired CPR/First Aid certificates. On 09/06/2023, licensee was supervising and caring for 5 infants while unable to provide current and up to date CPR/First Aid certificates. During today's inspection, licensee was in ratio with 3 infants and 5 preschool aged children. Licensee submitted CPR/First Aid certificate which expires 09/2025. Licensee has completed all plan of corrections.

AS OF 09/27/2023, ALL PLAN OF CORRECTIONS HAVE BEEN CLEARED AND LICENSEE RECEIVED CLEARANCE LETTER.

There were no regulatory violations observed during today's inspection.

Exit interview conducted and report was reviewed with the licensee, Shonta Edwards-Robinson. A Notice of Site Visit was given and must remain posted for 30 consecutive days.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2023
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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