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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421349
Report Date: 10/14/2021
Date Signed: 10/14/2021 03:02:07 PM

Document Has Been Signed on 10/14/2021 03:02 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:KIDS KONNECT PRESCHOOLFACILITY NUMBER:
013421349
ADMINISTRATOR:STINSON, IVYFACILITY TYPE:
850
ADDRESS:8800 FONTAINE STTELEPHONE:
(510) 569-5437
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 16DATE:
10/14/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ivy StinsonTIME COMPLETED:
03:10 PM
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Licensing Program Analyst Lisa Dyer met with Ivy Stinson, director, for an unannounced Plan of Correction inspection at 2:00 p.m. Present today is the director, 2 teachers and 16 preschool children.

The Personal Rights deficiencies previously cited on 10/6/21 are cleared. See Cleared POC dated 10/14/21.

An exit interview was conducted. Appeal rights were discussed. Notice of Site Visit must be posted for 30 days. This report must be available for public review for 3 years.
SUPERVISORS NAME: Phyllis Dyer
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2021
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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