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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421856
Report Date: 09/17/2019
Date Signed: 09/17/2019 01:12:07 PM

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:DUGARTE, SONIAFACILITY NUMBER:
013421856
ADMINISTRATOR:DUGARTE, SONIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 742-5508
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY:14CENSUS: 12DATE:
09/17/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Sonia DugarteTIME COMPLETED:
01:20 PM
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On 09/17/19 at 11:40am, Licensing Program Analysts Briana Plumboy and Elimika Woods met with licensee Sonia Dugarte for an UNANNOUNCED POC INSPECTION. Present for this visit was fingerprint clear and associated assistants A.Lopez, F.Morfin and A.Ramirez, 3 infants, and 9 preschoolers. The home was toured.

Today on 09/17/19, LPAs cleared the citations from 09/11/19 for the following:
1) Ratio
2) Fire Clearance
3) Enforcement Provisions
4) Staff Records
5) Children's files
6) Children's Roster (Lic.9040)

There are no deficiencies cited during today's inspection. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019
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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