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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412857
Report Date: 08/10/2022
Date Signed: 08/10/2022 10:03:05 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 08/10/2022 10:03 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 STE 1102
OAKLAND, CA 94612



FACILITY NAME:LOPEZ, LAURA & ARTUROFACILITY NUMBER:
013412857
ADMINISTRATOR:LOPEZ, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 352-2481
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY:14CENSUS: 9DATE:
08/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:32 AM
MET WITH:Laura Lopez- LicenseeTIME COMPLETED:
10:05 AM
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On 8/10/22 at 9:32am, Licensing Program Analyst (LPA) Briana Plumboy met with Licensee, Laura Lopez for an unannounced follow up annual inspection conducted on 5/26/22. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during this inspection was 3 infants, 3 preschool age children, 3 school age children, and licensees teenage daughter/assistant. The hours of operation are 7:30AM- 5:00 PM, Monday -Friday. The home is a single-family house consisting of, 3- bedrooms, 1-bathroom, living room, kitchen, backyard, and garage.
On-limit-areas are: Living room, dining room, hallway bathroom, kitchen, bedroom #3 and backyard.
Off Limit areas are: bedroom #1, bedroom #2, storage area in the back yard and Garage.
Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Laura Lopez and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Laura Lopez of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Laura Lopez.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
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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