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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423568
Report Date: 12/16/2024
Date Signed: 12/16/2024 04:05:33 PM

Document Has Been Signed on 12/16/2024 04:05 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:RODRIGUEZ, SILVIAFACILITY NUMBER:
013423568
ADMINISTRATOR/
DIRECTOR:		RODRIGUEZ, SILVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 520-5613
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
12/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:44 PM
MET WITH:Silvia RodriguezTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On 12/16/24, at 3:44pm, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced on a case management inspection and met with licensee Silvia Rodriguez. There were three infants in care.

LPA arrived to verify the status of the Licensee's day care, Licensee stated she is providing care to children.


Exit interview conducted.

Report, notice of site visit and appeal Rights provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
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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