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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418999
Report Date: 01/31/2023
Date Signed: 01/31/2023 10:35:24 AM

Document Has Been Signed on 01/31/2023 10:35 AM - 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:DUCK POND PRESCHOOL (THE)FACILITY NUMBER:
013418999
ADMINISTRATOR:COTTRELL, LOISFACILITY TYPE:
850
ADDRESS:3947 PARK BL.TELEPHONE:
(510) 530-0851
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY: 25TOTAL ENROLLED CHILDREN: 20CENSUS: 19DATE:
01/31/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Lois CottrellTIME COMPLETED:
11:00 AM
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On 01/31/2023. Licensing Program Analyst (LPA) Ashley Curry and Licensing Program Manager (LPM) Loretta Dyson conducted an unannounced Case Management inspection at Duck Pond Preschool. LPA and LPM met with the director, Lois Cottrell and explained the purpose of today's inspection. The facility self reported an unusual incident. LPA toured the facility, made observations, and conducted interviews. As a result of today's visit, there are no deficiencies that were cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted, appeal rights were given, and report was reviewed with the director Lois Cottrell.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2023
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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