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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420567
Report Date: 04/10/2024
Date Signed: 04/10/2024 01:56:44 PM

Document Has Been Signed on 04/10/2024 01:56 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CCLC - CLIF BASE CAMP CHILD CARE CENTERFACILITY NUMBER:
013420567
ADMINISTRATOR/
DIRECTOR:		WOO, LANIFACILITY TYPE:
850
ADDRESS:6529 HOLLIS STREETTELEPHONE:
(510) 596-6699
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 40DATE:
04/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Rayvonne GoodmanTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 4/10/24 at 12:45pm Licensing Program Analyst (LPA) Ashley Akinleye arrived at Clif Base Camp Child Center to deliver amended reports for a complaint investigation.

Complaints were signed and copies were provided.

Exit interview conducted with Rayvonne Goodman. Appeal rights provided to assistant director Rayvonne Goodman.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE: DATE: 04/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/10/2024
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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