<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073402205
Report Date: 10/23/2023
Date Signed: 10/23/2023 12:25:48 PM


Document Has Been Signed on 10/23/2023 12:25 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:RAMIREZ, ROSALBAFACILITY NUMBER:
073402205
ADMINISTRATOR:RAMIREZ, ROSALBAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 741-7848
CITY:SAN PABLOSTATE: CAZIP CODE:
94806
CAPACITY:14CENSUS: DATE:
10/23/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:52 AM
MET WITH:Rosalba RamirezTIME COMPLETED:
12:34 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On October 23, 2023 at 11:52am Licensing Program Analyst (LPA) Indira Loza met with Licensee Rosalba Ramirez for the purpose of conducting a POC visit. Present during today's inspection was the Licensee and two preschool age children. LPA conducted a tour for a health and safety check.

On August 1, 2023 the Licensee was cited for:
- Infant Safe Sleep CCR 102425(j)(2) - No sleep logs were being maintained for the infants in care
- Administration of Child Day Care Licensing HSC 1596.8662(b)(1) - Licensee did not have a current Mandated Reporter Certificate
- Ratio CCR Staffing Ratio and Capacity - Licensee was out of ratio
- Administration of Child Day Care Licensing CCR 1596.871(c)(1)(A) - Adult with no fingerprint clearance present in the facility

During today's visit, the Licensee was in ratio, Provided a copy of a current Mandated Reporter certificate, the uncleared adult obtained a fingerprint clearance on August 3, 2023, and the LPA reviewed a sleep log for the infants. Therefore, all four citations have been cleared.

There were no deficiencies cited during today's visit.
Report and Appeal Rights reviewed with and provided to Licensee Rosalba Ramirez.
Notice of Site Visit provided and must remain posted for 30 days.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:
DATE: 10/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1