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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420947
Report Date: 04/07/2023
Date Signed: 04/07/2023 02:07:07 PM


Document Has Been Signed on 04/07/2023 02:07 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:
013420947
ADMINISTRATOR:BATTLE, TIFFANIFACILITY TYPE:
850
ADDRESS:1400 - 6TH STTELEPHONE:
(510) 521-0595
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:75CENSUS: 29DATE:
04/07/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:57 PM
MET WITH:Cindy AckerTIME COMPLETED:
02:15 PM
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On 4/7/23, at 1:49PM, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced for a proof of correction inspection and met with owner Cindy Acker. Present in care were 29 preschoolers and an additional seven staff members.

On 4/5/23 a type A citation was issued to the center, LPA Fernandes arrived to the center to review the plan of correction. LPA obtained a copy of the center's staff schedules and breaks, the citation has now been cleared.


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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