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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013414800
Report Date: 02/22/2023
Date Signed: 02/22/2023 04:31:29 PM


Document Has Been Signed on 02/22/2023 04:31 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:CHILD UNIQUE MONTESSORI SCHOOL, THEFACILITY NUMBER:
013414800
ADMINISTRATOR:NILES, JOSEPHFACILITY TYPE:
850
ADDRESS:2226 ENCINAL AVENUETELEPHONE:
(510) 521-9227
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:30CENSUS: 24DATE:
02/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Cindy AckerTIME COMPLETED:
04:35 PM
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On 2/22/23 at 1:45pm, Licensing Program Analyst (LPA) Catherine Fernandes arrived to conduct a required annual inspection. LPA met with owner Cindy Acker and observed four additional finger print cleared staff members and 24 preschoolers in care.

LPA did a walk through of the center and do to time restrictions the annual inspection will be continued at a later date.




Exit interview conducted with Cindy Acker
Report and Appeal Rights provided
Notice of site visit provided
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2023
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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