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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073403767
Report Date: 09/01/2022
Date Signed: 09/01/2022 11:14:30 AM


Document Has Been Signed on 09/01/2022 11:14 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, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:SANDOVAL, LYDIAFACILITY NUMBER:
073403767
ADMINISTRATOR:SANDOVAL, LYDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 565-2021
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:14CENSUS: 3DATE:
09/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Lydia SandovalTIME COMPLETED:
11:30 AM
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 09/01/2022 at 10:40 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced case management inspection at Lydia Sandoval large family child care home. LPA met licensee, Lydia Sandoval and explained the purpose of today's inspection.

At the time of inspection, 3 children were in care and 10 children are enrolled.

On 08/15/2022, during annual inspection, LPA observed play structure not anchored in the backyard of outdoor play area. LPA informed licensee of play structure was not being anchored properly. Licensee stated she would have play structure anchored immediately. During today's inspection, LPA inspected play structure and it is currently not anchored. LPA has instructed licensee that children in care cannot use play structure until it is properly anchored and approved by licensing. LPA has requested licensee to contact LPA Watts once play structure is anchored. LPA Watts will return to facility to inspect play structure.

Exit interview was conducted and report was reviewed with the licensee, Lydia Sandoval. A Notice of Site Visit was given and must remain posted for 30 consecutive days.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022
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