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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407102
Report Date: 02/27/2023
Date Signed: 02/27/2023 12:28:28 PM


Document Has Been Signed on 02/27/2023 12:28 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:ROCHA, NORMAFACILITY NUMBER:
073407102
ADMINISTRATOR:ROCHA, NORMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 679-0826
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:14CENSUS: 1DATE:
02/27/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Norma RochaTIME COMPLETED:
12:30 PM
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On 02/27/2023 at 11:00 AM, Licensing Program Analysts (LPA) Christina Watts conducted an unannounced case management inspection. LPA met with licensee, Norma Rocha and explained the purpose of today's inspection. Licensee wants dining room as an on limits area. Currently, dining room is an off limit area for children in care. Licensee stated she wants to use dining room area as a space for school age children to do there homework.

LPA inspected the dining room. LPA observed a wine storage in the dining room. LPA informed licensee that wine storage must have a lock when children are in care. Licensee stated she will purchase a lock for wine storage. Plugs and outlets were covered and made inaccessible for children in care. All dangerous and hazardous items are out of reach of children or in a latched cabinet inaccessible to children.

Dining room is approved for IN USE for day-care as of 02/27/2023.

Exit interview was conducted with licensee, Norma Rocha and the report was signed acknowledging receipts of documents.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
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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