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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423867
Report Date: 10/22/2024
Date Signed: 10/22/2024 03:16:30 PM

Document Has Been Signed on 10/22/2024 03:16 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:RAMIREZ, GUADALUPEFACILITY NUMBER:
013423867
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 4DATE:
10/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:15 PM
MET WITH:Guadalupe RamirezTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 10/22/2024 at 3:15PM Licensing Program Analysts (LPA's) Kareeca "Reeca" Sykes and Diana Campos conducted an UNANNOUNCED CASE MANAGEMENT- Other during an Capacity Increase Inspection to add Bedroom 2 as an ON-LIMIT area. LPA's met with licensee Guadalupe Ramirez to discuss the purpose of today's visit and was granted access into the facility to conduct a tour for health and safety. During the visit there was four (4) children in care (2 toddlers and 2 infant children).

During the inspection LPA's inspected all ON-LIMIT areas of the home including the bedroom that the licensee is requesting to be on limits.

The ON-LIMIT AREAS: The living room, kitchen, bedroom 1, the bathroom to the left of bedroom 1, and the backyard
The OFF - LIMITS AREAS: Bedroom 3, the bathroom located in bedroom 3

The bedroom has been approved as an ON-LIMITS area:

Exit interview conducted, appeal rights were given, and report was reviewed with the Licensee Guadalupe Ramirez.

Notice of site visit was provided to licensee and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Kareeca Sykes
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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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