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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423851
Report Date: 01/31/2023
Date Signed: 01/31/2023 02:28:56 PM

Document Has Been Signed on 01/31/2023 02:28 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:WRIGHT, OLIVIA & MONTES-PAREDES, LESLIEFACILITY NUMBER:
013423851
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
01/31/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:07 PM
MET WITH:Olivia WrightTIME COMPLETED:
02:34 PM
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On January 31, 2023 Licensing Program Analyst (LPA) Indira Loza arrived at the facility to conduct an announced Case Management visit for an Increase Capacity. LPA met with Licensee Olivia Wright. Present for the inspection were the Licensee, the Co-Licensee and six Preschool-Age children.

The home is a single family home consisting of three bedrooms, two bathrooms, a kitchen, a dining room, and a living room. The two bedrooms are connected by a bathroom. There is a large backyard that is shared with the house behind the facility. The Off Limit areas will be the Licensee's bedroom to the left of the kitchen and the backyard. The Licensee will ensure the off limit areas will be inaccessible by closed and/or locked doors, safety gates and visual supervision. The On Limit areas are both bedrooms and the bathroom on the left from the entrance, the living room and dining room which are on the right from the entrance, and the bathroom next to the kitchen. The isolation area will be in the bedroom to the left from the kitchen. The backyard will not be used for outdoor play, instead the front yard and park will be utilized for outdoor play. LPA observed a working Carbon Monoxide Detector and smoke detector, also a 3A40BC fire extinguisher.


The facility has been approved for a capacity Increase effective January 31, 2023.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2023
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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