<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420549
Report Date: 03/23/2023
Date Signed: 03/23/2023 05:18:57 PM


Document Has Been Signed on 03/23/2023 05:18 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:ALBANY CHILDREN'S CENTERFACILITY NUMBER:
013420549
ADMINISTRATOR:MANSKER, ANNAFACILITY TYPE:
850
ADDRESS:720 JACKSON STREETTELEPHONE:
(510) 559-6590
CITY:ALBANYSTATE: CAZIP CODE:
94706
CAPACITY:85CENSUS: 53DATE:
03/23/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Danielle EichnerTIME COMPLETED:
05:33 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On Thursday, March 23, 2023 at 1:40 PM, Licensing Program Analyst (LPA) Caroline Colson met with Danielle Eichner, Office Support, for an unannounced Case Management Inspection. Anne Shin, Assistant Superintendent of Educational Services arrived during the inspection. The purpose of this inspection was to investigate an unusual incident report. There are 53 children and 10 staff members present. Interviews were conducted.

Exit interview was conducted. Appeal Rights were given and discussed.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1