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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405987
Report Date: 11/01/2022
Date Signed: 11/01/2022 11:58:22 AM


Document Has Been Signed on 11/01/2022 11:58 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:TERRIQUEZ, MARIAFACILITY NUMBER:
073405987
ADMINISTRATOR:TERRIQUEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 207-3844
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:14CENSUS: 0DATE:
11/01/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Maria TerriquezTIME COMPLETED:
12:00 PM
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On 11/1/22 at 11:30 AM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced case management for Plan of Corrections. LPA met with the licensee Maria Terriquez and discussed the purpose of the inspection. Licensee has a Large Family Child Care Home with a capacity of 14. Present in the home at the time of the inspection is just the licensee and licensee's adult son.

During the inspection operations of a family childcare home were discussed. Letter of Deficiency Citation Cleared was given to licensee for two Type B cited on 9/28/22 for Operation of a Family Child Care Home and General Provisions and Definitions.

There were no deficiencies cited during today's inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Maria Terriquez.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle SuttonTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2022
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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