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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422034
Report Date: 03/09/2023
Date Signed: 03/09/2023 01:28:23 PM


Document Has Been Signed on 03/09/2023 01:28 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:WILDWOOD CHILDRENS SCHOOLFACILITY NUMBER:
013422034
ADMINISTRATOR:HA, TAEFACILITY TYPE:
850
ADDRESS:8 WILDWOOD AVE.TELEPHONE:
(510) 922-9197
CITY:OAKLANDSTATE: CAZIP CODE:
94610
CAPACITY:57CENSUS: DATE:
03/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Anita LeeTIME COMPLETED:
03:15 PM
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On 03/09/2023 Licensing Program Analyst (LPA) A. Curry arrived at the facility to follow up on a plan of correction for two citations that was due on 03/03/2023. LPA met with site supervisor Anita Lee to explain the purpose of today’s visit. Anita Lee stated she emailed LPA the requested documents to clear the deficiencies on 03/02/2023. Anita was able to provide proof of email sent on 03/02/2023. The deficiencies have been cleared as of 03/02/2023.


Exit interview conducted, appeal rights were given, and report was reviewed with site supervisor Anita Lee.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley CurryTELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2023
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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