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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408898
Report Date: 03/17/2022
Date Signed: 03/17/2022 01:51:11 PM


Document Has Been Signed on 03/17/2022 01:51 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:DESTINY ACADEMYFACILITY NUMBER:
073408898
ADMINISTRATOR:SMITH, ADRIENNEFACILITY TYPE:
850
ADDRESS:1411 EAST LELAND ROADTELEPHONE:
(925) 439-8989
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:75CENSUS: 2DATE:
03/17/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Crystal Smith TIME COMPLETED:
01:50 PM
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On 3/17/22 at 1:00 PM Licensing Program Analyst (LPA) Michelle Sutton conducted an announced case management visit for a new play yard structure on the facility's play yard. LPA met with administrator Crystal Smith and present for the inspection was licensee/owner Adrienne Smith, 1 teacher and 2 preschool children.

The outdoor activity space provides shaded rest area for the children. The equipment and activity area has no hazardous items. The areas around and under high climbing play structure is cushioned with wood chips that absorbs falls. The play yard is enclosed by a fence to protect children and to keep them in the outdoor activity area. Outdoor activity space is in compliance with Title 22 Regulations. Manager Approval before being used.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the administrator Crystal Smith.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle SuttonTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2022
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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