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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423009
Report Date: 01/18/2024
Date Signed: 01/18/2024 01:31:32 PM

Document Has Been Signed on 01/18/2024 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ZULUETA PINEDA, CLAUDIAFACILITY NUMBER:
013423009
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
01/18/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:39 PM
MET WITH:Claudia ZuluetaTIME COMPLETED:
03:01 PM
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Licensing Program Analyst Sidney Cortez, met with licensee Claudia Zulueta for an Unannouced Annual Random Inspection. Present for this visit was the licensee Claudia Zulueta and 1 pre school age, and 1 kindergarten age child (total of 2 children). The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 6:00AM until 6:00 PM, MONDAY-FRIDAY, and 10AM-5pm on weekends.
The facility is a one story level house. It consists of a living room, 3 bedrooms, one bathroom, kitchen, garage and backyard.
ON LIMIT AREAS are: the living room, the 2 bedrooms located on the right side of the hallway, and the hallway bathroom.
OFF LIMIT AREAS are: the kitchen, the master bedroom and the garage.
The ISOLATION AREA will be the bedroom located on the right side of the hallway.There are no pools, hot tubs or any other bodies of water. All hazardous materials and toxins are kept out of the reach of children. Per licensee, there are no firearms in the home. The home has a working smoke detector, carbon monoxide detector, working telephone, and First Aid Kit.


The home has a fully charged (3A40BC) fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee CPR and First Aid certificate is current and expires (May 2025). The licensee's mandated reporter is current and will expire in April 2025. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on Dec 2023.


2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2024
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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