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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
010211880
Report Date:
06/06/2024
Date Signed:
06/06/2024 02:03:38 PM
Document Has Been Signed on
06/06/2024 02:03 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:
TERRELL, BARBARA
FACILITY NUMBER:
010211880
ADMINISTRATOR/
DIRECTOR:
TERRELL, BARBARA
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(510) 436-6043
CITY:
OAKLAND
STATE:
CA
ZIP CODE:
94601
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
14
CENSUS:
8
DATE:
06/06/2024
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:
Barbara Terrell
TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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LPA D. Campos arrived at the facility and met with licensee Barbara Terrell for the purpose of conducting a Case Management inspection to deliver an amended report. Present during this visit were 8 preschool children in care and 2 assistants.
LPA corrected a statement that was inaccurate in the Annual Required report dated 4/21/2023. Please see the amended report LIC809 and LIC809C for corrections made.
No citations issued as a result of this visit.
Exit interview conducted and report reviewed with licensee Barbara Terrell.
Notice of Site Visit provided and must remain posted for 30 days.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Diana Campos
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/06/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/06/2024
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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