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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408308
Report Date: 12/20/2022
Date Signed: 12/20/2022 01:31:54 PM


Document Has Been Signed on 12/20/2022 01:31 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:DABUL MOLINA, MARIAFACILITY NUMBER:
073408308
ADMINISTRATOR:DABUL MOLINA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 451-5833
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:14CENSUS: 5DATE:
12/20/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Maria Dabul MolinaTIME COMPLETED:
01:31 PM
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On 12/20/22 at 1:10 PM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced case management for Plan of Corrections. LPA met with the licensee Maria and discussed the purpose of the inspection. Licensee has a Large Family Child Care Home with a capacity of 14. Present for the inspection were licensee and 5 preschool children.

During the inspection operations of a family childcare home were discussed. Licensee stated she has her mother in-law who is fingerprinted and associated to the facility as an assistant, when operating as a Large FCCH. Letter of Deficiency Citation Cleared was given to licensee for two Type B cited on 12/2/22 for Staffing Ratio and Capacity and Personnel Requirements.

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 Dabul Molina.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle SuttonTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2022
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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