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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423753
Report Date: 01/16/2024
Date Signed: 01/16/2024 12:04:46 PM

Document Has Been Signed on 01/16/2024 12:04 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:LITTLE IMAGES HIGHER LEARNING ACADEMYFACILITY NUMBER:
013423753
ADMINISTRATOR:BESSIE MARIE SHOLESFACILITY TYPE:
850
ADDRESS:5909 CAMDEN STREETTELEPHONE:
(510) 491-3411
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 6DATE:
01/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:BESSIE MARIE SHOLESTIME COMPLETED:
12:15 PM
NARRATIVE
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On January 16, 2024 Licensing Program Analyst (LPA) Tasha Alexander met with Center owner Bessie Marie Sholes to deliver the findings to a complaint investigation. During today's visit it was revealed that two adults were residing in the building on the side not occupied by/licensed for day care.
Both adults have since moved out of the building.

Please see attached 809-d for citation

An exit interview was conducted. A notice of site visit was posted.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2024
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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Document Has Been Signed on 01/16/2024 12:04 PM - It Cannot Be Edited


Created By: Tasha Hackett-Alexander On 01/16/2024 at 11:09 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LITTLE IMAGES HIGHER LEARNING ACADEMY
FACILITY NUMBER: 013423753

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2024
Section Cited
CCR
101170(e)(1)

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101170 Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:
(1) Obtain a California clearance or a criminal record exemption as required by the Department
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Licensee will ensure to have all adults finger printed and cleared before volunteering, working or residing at the facility. The 2 adults are no longer residing at the facility.
TODAY A CIVIL PENALTY WILL BE ASSESSED


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THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY: OBSERVATIONS AND RECORDS REVIEW WHICH REVEALED TWO ADULTS RESIDING IN THE UNUSED SIDE OF THE BUILDING
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Loretta Dyson
LICENSING EVALUATOR NAME:Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2024


LIC809 (FAS) - (06/04)
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