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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416205
Report Date: 06/28/2023
Date Signed: 06/28/2023 01:51:46 PM


Document Has Been Signed on 06/28/2023 01:51 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:SOLVAL, MIRIAMFACILITY NUMBER:
013416205
ADMINISTRATOR:SOLVAL, MIRIAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 537-9037
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY:14CENSUS: 3DATE:
06/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:46 PM
MET WITH:Miriam SolvalTIME COMPLETED:
03:39 PM
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Licensing Program Analyst Sidney Cortez, met with licensee Miriam Solval for an Unannounced Annual Random Inspection. Present for this visit was the licensee Miriam Solval, one infant, 2 school age children and her fingerprinted cleared assistant Julietta Arreloa.


The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:00AM until 5PM, MONDAY-SATURDAY.The home is single story. The home consists of three bedrooms, two bathrooms, kitchen, living room, dining room, family room, and a garage. The home is neat and clean with heating and ventilation for safety and comfort.

The On Limit Areas are the family room, the half bathroom, the kitchen, the living room, and dining room, and backyard. Off Limit Areas are the garage,three bedrooms and full bathroom. These areas are inaccessible by closed and/or locked doors and visual supervision. The Isolation Area will be in the living room. The home has a working smoke detector, carbon monoxide detector, working telephone, and First Aid Kit.


The home has a fully charged (3A40BC) fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee CPR and First Aid certificate is current and expires (Feb 2025). The licensee's mandated reporter training is complete and will expire on June 2025. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on May 9, 2023. 2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney CortezTELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2023
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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