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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422566
Report Date: 10/29/2020
Date Signed: 10/29/2020 02:28:57 PM

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:GREIG, ALEXIS & EDWARDFACILITY NUMBER:
013422566
ADMINISTRATOR:GREIG, ALEXISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 350-6081
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY:14CENSUS: 11DATE:
10/29/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Alexis/Edward GreigTIME COMPLETED:
12:15 PM
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On 10/29/20 at 11:45 AM Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Case Management inspection at Alexis & Edward Greig's family child care home. LPA spoke with Licensees, Edward, Alexis and staff Harmonie. Due to COVID restrictions, this inspection was done through Zoom call.

LPA followed up on an incident that was self reported by the facility. Interviews were conducted and relevant documents obtained. There were 11 children and 2 staff present.

No deficiencies were issued today. Exit Interview was conducted, where this report was reviewed and discussed with the Licensee. Report will be sent to obtain signatures; to be returned by end of day 10/30/20.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020
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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