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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070212743
Report Date: 03/07/2024
Date Signed: 03/07/2024 11:55:47 AM

Document Has Been Signed on 03/07/2024 11:55 AM - 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:WCCUSD - DOVERFACILITY NUMBER:
070212743
ADMINISTRATOR:ATTIG, ZEENAFACILITY TYPE:
850
ADDRESS:1871 21ST STREETTELEPHONE:
(510) 231-1420
CITY:SAN PABLOSTATE: CAZIP CODE:
94806
CAPACITY: 24TOTAL ENROLLED CHILDREN: 40CENSUS: 0DATE:
03/07/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Zeena AttigTIME COMPLETED:
12:00 PM
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On 03/07/2024 at 11:10 AM, Licensing Program Analyst (LPA) Christina Watts conducted a Plan of Correction inspection at WCCUSD - Dover. Dover Classroom in on the campus of Dover Elementary School. LPA met with Director/Teacher Zeena Attig and explained the purpose of today's visit. During today's inspection, there were no children in care and 40 children enrolled in the facility. There were also 2 staff present during inspection. All staff caring and supervising children have Criminal Record Clearance per WCCUSD.

LPA is following up on a citation given to the facility on 12/08/2023 for failure to conduct Lead Testing for classroom. Facility has requested for an extension for the Plan of Correction and facility was given an extension until 03/08/2024. Per Asst Project Manager, Jordan Murphy, the facility has completed lead testing. The Asst Project Manager will submit documentation to licensing.

AS OF 03/07/2024, THE CITATION HAS BEEN CLEARED AND THE CLEARANCE LETTER HAVE BEEN PROVIDED TO THE FACILITY.

During today's inspection, there were no violations observed.

Exit interview conducted and report was reviewed with Director/Teacher Zeena Attig. A Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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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