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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408734
Report Date: 02/25/2025
Date Signed: 02/25/2025 04:20:48 PM

Document Has Been Signed on 02/25/2025 04:20 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:HERNANDEZ LOPEZ, SANDRAFACILITY NUMBER:
073408734
ADMINISTRATOR/
DIRECTOR:		SANDRA HERNANDEZ LOPEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 205-6312
CITY:SAN PABLOSTATE: CAZIP CODE:
94806
CAPACITY: 14TOTAL ENROLLED CHILDREN: 17CENSUS: 7DATE:
02/25/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:05 PM
MET WITH:Sandra Hernandez LopezTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On February 25, 2025, at 3:05pm, Licensing Program Analyst (LPA) Indira Loza and Mario Caro arrived for another matter and met with Licensee Sandra Hernandez Lopez. Present in care were 7 preschoolers, the licensee, and an Assistant.

During today's visit, it was found that the licensee's assistant Luvi LopezCante, does not have a fingerprint clearance. Although she did her fingerprints on 2/13/25, the status of the fingerprints were not received. One Type B citation will be issued today.

Exit interview conducted.
Report and Appeal Rights provided.
Notice of Site Visit provided and must remain posted.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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 2
Document Has Been Signed on 02/25/2025 04:20 PM - It Cannot Be Edited


Created By: Indira Loza On 02/25/2025 at 03:55 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: HERNANDEZ LOPEZ, SANDRA
FACILITY NUMBER: 073408734

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2025
Section Cited

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(d) All individuals subject to a criminal record review...shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met as evidenced by:
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Based on records reviewed it was determined that the licensee's assistant did her fingerprints which did not clear.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mayla Mendoza
LICENSING EVALUATOR NAME:Indira Loza
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2025


LIC809 (FAS) - (06/04)
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