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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422770
Report Date: 08/10/2022
Date Signed: 08/10/2022 10:57:38 AM

Document Has Been Signed on 08/10/2022 10:57 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:DING, LAN & MO, YA QINGFACILITY NUMBER:
013422770
ADMINISTRATOR:DING, LAN & MO, YA QINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 375-9428
CITY:ALBANYSTATE: CAZIP CODE:
94706
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
08/10/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:44 AM
MET WITH:Lan DingTIME COMPLETED:
11:12 AM
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On Wednesday, August 10, 2022 at 9:44 AM, Licensing Program Manager (LPM l) Mayla Mendoza and Licensing Program Analyst (LPA) Caroline Colson met with Lan Ding for a plan of correction inspection. There are four infants present. The purpose of this inspection is to ensure that the deficiency was corrected. The deficiency was corrected.

There are no deficiencies cited during this inspection. Appeal Rights were given and discussed. Exit interview was conducted.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2022
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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