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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
013423772
Report Date:
03/12/2025
Date Signed:
03/12/2025 05:30:15 PM
Document Has Been Signed on
03/12/2025 05:30 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:
GRAND LAKE MONTESSORI
FACILITY NUMBER:
013423772
ADMINISTRATOR/
DIRECTOR:
ALICIA COOPER
FACILITY TYPE:
860
ADDRESS:
466 CHETWOOD STREET
TELEPHONE:
(510) 836-4313
CITY:
OAKLAND
STATE:
CA
ZIP CODE:
94610
CAPACITY:
195
TOTAL ENROLLED CHILDREN:
110
CENSUS:
106
DATE:
03/12/2025
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:
Adrienne Pratt
TIME VISIT/
INSPECTION COMPLETED:
05:40 PM
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Licensing Program Analyst (LPA) Cherie Acosta and Kayla Merchant conducted an unannounced case management visit regarding a self reported incident. LPAs met with Adrienne Pratt.
The facility has two classroom that operate in the church. The church had construction the first weekend of March. It was discovered that the church building has asbestos. The children were moved to the facility's other classrooms that are located in separate buildings away from the church. During the visit LPA's observed facility using an unlicensed office area to care for 12 children. Facility was also using an outdoor classroom area to care for 10 children.
Facility shall submit an updated application (LIC200A) and facility sketch with room measurements and classroom assignments electronically by 3/14/25 to oaklandchildcarero@dss.ca.gov. Facility shall submit original application (LIC200A) and facility sketch with room measurements and classroom assignments to CCL by 3/17/25.
Adrienne was also informed that there must be indoor classroom space for all children in care.
Notice of Site Visit was Provided and must be posted for 30 days.
Exit interview and report reviewed with Leta Koerber.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Cherie Acosta
LICENSING EVALUATOR SIGNATURE
:
DATE:
03/12/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/12/2025
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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