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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409261
Report Date: 03/30/2022
Date Signed: 03/30/2022 02:22:48 PM

Document Has Been Signed on 03/30/2022 02:22 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:PHILLIPS, MEESHAFACILITY NUMBER:
073409261
ADMINISTRATOR:PHILLIPS, MEESHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 617-9790
CITY:HERCULESSTATE: CAZIP CODE:
94547
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/30/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Meesha PhillipsTIME COMPLETED:
03:00 PM
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On 03/30/2022 Licensing Program Analysts (LPAs) A. Curry and C. Watts conducted an unannounced case management inspection to clear a deficiency that was cited on 03/24/2022. LPAs met with licensee Meesha Phillips to discuss the purpose of today's visit. Licensee was cited for providing unlicensed care. LPAs toured the facility and verified no children were in care. LPA A. Curry contacted the families of the children enrolled prior to the inspection and confirmed child care services have been temporarily suspended as of 03/25/2022. At today's inspection licensee received a Letter stating deficiency has been cleared. Exit interview conducted, appeal rights were given, and report was reviewed with Meesha Phillips.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2022
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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