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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700233
Report Date: 02/21/2024
Date Signed: 02/21/2024 07:19:48 AM

Document Has Been Signed on 02/21/2024 07:19 AM - 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:MOULAS, MARIETTAFACILITY NUMBER:
015700233
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
02/21/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Marietta MoulasTIME COMPLETED:
11:02 AM
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Licensing Program Analyst Sidney Cortez, conducted a case management visit for an Increase Capacity Change. Present for this visit was the licensee, Mariettta Moulas and her fingerprint cleared husband/assistant Dean Moulas and, and 2 infants (6 total).

The facility currently operates from Monday through Friday from 7:00am until 6:00pm. The home is 1 story. The home consists of 3 bedrooms, 2 bathroom, living room, dining room, kitchen, backyard and garage. The OFF LIMIT AREAS is the 2 bedrooms, and the other bathroom (master bedroom). The
ON LIMIT AREAS are the 1 bedroom (napping area), living room, dining room, hallway bathroom (hallway), play area in the garage and backyard. The ISOLATION AREA is the living room area.


There is no pool or any type of bodies of water in the home. Per applicant, there is no fire-arm in the house. The home is neat and clean with heating and ventilation for safety and comfort.

The home has one fully charged fire extinguisher (model 2A10BC), and working smoke/carbon monoxide detectors, first aid kit, emergency supplies, and working telephone. Licensee’s CPR and First Aid certificates are current and both certificates will expire on Feb 2025. Licensee has a current mandated reporter training which will expire in January 2025


The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on January 2024. (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. This facility is recommended for increase of capacity .

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2024
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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