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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408898
Report Date: 03/23/2022
Date Signed: 03/23/2022 02:45:18 PM


Document Has Been Signed on 03/23/2022 02:45 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: 6DATE:
03/23/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:17 PM
MET WITH:Adrienne Smith and Crystal SmithTIME COMPLETED:
03:00 PM
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On 03/23/2022, Licensing Program Analyst (LPA), Melissa Guirit conducted an unannounced inspection to measure the new play yard to be used for children. Previously, LPA Sutton conducted an inspection to look at the yard for completion. The facility will utilize the new play yard and the sectioned parking lot that was previously measured by LPM Dyson. The measurements for the new play yard are as follows:

OUTDOORS: 7,174.99 sq feet = 95 children

The facility may now use the new play yard when ready and no waiver is needed for the outdoor play yard. Exit interview conducted with Adrienne Smith and Crystal Smith and a copy of the report provided.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa GuiritTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2022
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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