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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420975
Report Date: 12/01/2022
Date Signed: 12/01/2022 12:05:43 PM

Document Has Been Signed on 12/01/2022 12:05 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:ACADEMIA DE MI ABUELAFACILITY NUMBER:
013420975
ADMINISTRATOR:REIMANN, CYNTHIAFACILITY TYPE:
850
ADDRESS:2162 MOUNTAIN BLVD STE 300TELEPHONE:
(510) 336-7082
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY: 53TOTAL ENROLLED CHILDREN: 53CENSUS: 26DATE:
12/01/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Cynthia ReimannTIME COMPLETED:
12:15 PM
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On 12/1/2022, at 9:06am, Licensing Program Analysts (LPAs) Catherine Fernandes and Indira Loza arrived on a proof of correction visit and met with Director Cynthia Reimann.

During the visit LPA Fernandes went over missing documents for the children and staff files with Director and came up with a system for the center.

While at the center LPA Fernandes observed tight fitting covers for the trash cans, Director explained the new toileting system to ensure staff is in charge of clean up and LPA observed no expired or leftover medication at the center.


LPA Fernandes and Loza provided Proof of Correction letter to the Director Reimann.


Exit interview conducted
Report and Appeal Rights Provided
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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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