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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422034
Report Date: 08/31/2023
Date Signed: 08/31/2023 10:03:54 AM


Document Has Been Signed on 08/31/2023 10:03 AM - 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:
08/31/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Anita LeeTIME COMPLETED:
11:30 AM
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On 08/31/2023 at 10:35AM Licensing Program Analyst (LPA), A. Curry conducted a case management inspection to follow up on deficiencies that were cited at the facility. LPA toured the facility, made observations, and retrieved relevant documentation. No Deficiencies are being cited.


Exit interview conducted, appeal rights were given, and report was review with the director Anita Lee.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Ashley CurryTELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2023
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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