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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407813
Report Date: 09/27/2023
Date Signed: 09/27/2023 01:33:14 PM


Document Has Been Signed on 09/27/2023 01:33 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:PEREZ, SILVIAFACILITY NUMBER:
073407813
ADMINISTRATOR:PEREZ, SILVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 566-6005
CITY:RICHMONDSTATE: CAZIP CODE:
94804
CAPACITY:14CENSUS: 11DATE:
09/27/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Silvia PerezTIME COMPLETED:
01:40 PM
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced Plan of Correction inspection. LPA met with licensee, Silvia Perez. During today's inspection there were 8 infants and 3 preschool children in care.

Inspection report dated 9/26/23 indicates there were 7 infants and 4 preschool children in care. It was discovered during today's inspection that during the inspection on 9/26/23, LPA was given a file for a preschool child, C3, that is no longer enrolled and was not given a file for one of the infants, C12, in care. During the inspection on 9/26/23 the actual count of children in care was 8 infants and 3 preschool children.

Licensee was cited on 9/26/23 for operating out of ratio. Licensee was given a plan of correction to come in compliance with the required ratio by close of business of 9/26/23. During today's inspection licensee continues to operate out of ratio. A civil penalty of $100.00 is assessed today for failure to correct citation issued 9/26/23. Parents of 4 infants in care were called and the 4 infants were picked up during the inspection.

Licensee understands the ratio stated on the licensee and shall remain in compliance with the ratio at all time.

Notice of Site Visit was provided and must be posted for 30 days.

Report reviewed with Silvia Perez.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie AcostaTELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2023
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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