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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423622
Report Date: 03/09/2021
Date Signed: 03/09/2021 06:19:53 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:DIOUF, NDEYEFACILITY NUMBER:
013423622
ADMINISTRATOR:DIOUF, NDEYEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 812-0783
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:14CENSUS: 0DATE:
03/09/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
05:50 PM
MET WITH:Ndeye DioufTIME COMPLETED:
06:20 PM
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On 3/9/21 at 5:50pm, Licensing Program Manager (LPM) Loretta Dyson arrived at the facility for an announced prelicensing inspection. LPM met with the applicant Ndeye Diouf. This is a follow up inspection to the previous prelicensing inspection on 2/19/21. The facility has submitted an application for a large family child care home license at the above address.

LPM inspected the outdoor area and observed that the applicant has installed a fence that meets the height and spacing requirements for fencing around bodies of water. The fence is secure and the body of water on the other side of the cement wall in the backyard is inaccessible.

All requirements have been met and the facility will be licensed effective today, 3/9/21. An exit interview was conducted with the applicant. This report will remain on file for 3 years.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2021
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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