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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
073408864
Report Date:
08/29/2022
Date Signed:
08/29/2022 03:46:28 PM
Document Has Been Signed on
08/29/2022 03:46 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:
KIDDIE ACADEMY
FACILITY NUMBER:
073408864
ADMINISTRATOR:
LARONDA LEVIAS-MALLORY
FACILITY TYPE:
850
ADDRESS:
1620 NERLOY RD.
TELEPHONE:
(925) 261-6717
CITY:
OAKLEY
STATE:
CA
ZIP CODE:
94561
CAPACITY:
114
TOTAL ENROLLED CHILDREN:
114
CENSUS:
51
DATE:
08/29/2022
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME BEGAN:
02:30 PM
MET WITH:
Laronda Levias-Mallory
TIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced case management visit in regards to a self reported incident.
LPA met with Director Laronda Levias-Mallory and spoke with her about the incident.
LPA obtained copies of the facility roster and personnel report.
There are no deficiencies cited during today's visit.
Notice of Site Visit was provided and must be posted for 30 days.
Exit interview and report reviewed with Director Laronda Levias-Mallory.
SUPERVISORS NAME
:
Sherelle Johnson
LICENSING EVALUATOR NAME
:
Cherie Acosta
LICENSING EVALUATOR SIGNATURE
:
DATE:
08/29/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/29/2022
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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