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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700263
Report Date: 10/30/2024
Date Signed: 10/30/2024 05:06:25 PM

Document Has Been Signed on 10/30/2024 05:06 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 CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:PEREDA LOPEZ, ZAHAIRAFACILITY NUMBER:
015700263
ADMINISTRATOR/
DIRECTOR:		PEREDA LOPEZ, ZAHAIRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 449-2984
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
10/30/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:50 PM
MET WITH:Zahaira Pereda LopezTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
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On October 30, 2024 at approximately 2:50pm Licensing Program Analyst (LPA) Randy Miranda arrived for an unannounced annual inspection for health and safety. Present for the inspection was the licensee and 4 children in care (one infant; one 3-year-old; one 4-year-old; and one 4.5-year-old). The facility is in ratio today. Hours of operation are Monday-Friday 7:30 to 6:00pm.

The facility is a single story 3-bedroom, 2 bath home with an attached 2-car garage (including an inground swimming pool in the back yard with a 5-foot fence surrounding the pool – see below). The back yard has a gazebo and a small pumphouse for the pool. There is a living room with a covered fireplace, family room with a faux fireplace feature built into the wall, dining room, large kitchen (half has the stove and sink area, the other half was formerly the kitchen and has been covered into a bar area), three bedrooms (1 master with an attached sunroom), attached 2-car garage an enclosed (fenced) side and backyard area. The home is owned by the licensee. The home is neat and clean with heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the on-limits bedroom away from the other children in care.

POOL: The backyard has an inground pool with a five-foot fence surrounding the perimeter. The pool fence is constructed with a mesh material to allow for visual view into the pool. There is a gate that swings away from the pool and has a self-closing and self-latching gate with the latch at the top.



There is a faux fireplace on the wall of the family room (day care area) with an iron gate to prevent child access. This feature will not be used when children are present. Children have cubbies for personal item storage. A copy of the deed is available showing the licensee owns the property. Per licensee, there are no firearms in the home. The home has a fully charged 2A10BC fire extinguisher mounted on the kitchen wall and a second extinguisher under the kitchen sink. There are working smoke detectors throughout the home; a carbon monoxide detector (tested and functioning), and a working telephone. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 9/16/2024. All required licensing documents are posted and visible for public review.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PEREDA LOPEZ, ZAHAIRA
FACILITY NUMBER: 015700263
VISIT DATE: 10/30/2024
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On-limit-areas include: Entryway of the home, family room, bar area of the kitchen, the NW side bedroom for napping and main house bathroom on left side of the bedroom for napping, and main back yard area, the gazebo and the outside perimeter of the pool fence surrounding the pool in the backyard. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area.
Off-limit-areas include: The living room, dining room; hallway leading to the SW and NW bedrooms, the bedroom on the SW side and the master bedroom and bathroom on the NW side; the sunroom, the attached 2-car garage, front yard, and fenced side yards and inground pool in the backyard and pool pumphouse. The off-limit areas are inaccessible by closed and/or locked doors, child gates and/or by child supervision.

Licensee has ample age-appropriate toys and learning materials inside and outside. In the backyard there is a large children’s play structure in the backyard for climbing with a slide and swings and is securely attached to the ground. There is a gazebo for seating with covered gas and charcoal barbeques, and a covered pizza oven and a non-functioning fire pit. If the fire pit is repaired, it will not be used while children are in care. There is a covered sandbox containing clean sand and toys and other age-appropriate toys for children to play with.

Children's files were reviewed and found to be complete and in good order. The facility roster was reviewed, and a copy obtained. The licensee owns the property and just recently subscribed to liability insurance (Home Insurance recommended). In addition, LIC282 forms with parent’s acknowledgement of no liability insurance were signed/dated and placed in each child’s file. LIC 282 forms will be archived once copies of Liability Insurance is made available.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PEREDA LOPEZ, ZAHAIRA
FACILITY NUMBER: 015700263
VISIT DATE: 10/30/2024
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The licensee’s Health and Safety training was completed 6/13/2021 (including the nutrition and Lead Poisoning Prevention requirements), CPR and First Aid certificate is current and expires 7/31/2025. Mandated Reporter was completed and expires 8/15/2026. The licensee is in compliance with all immunization laws which pertains to day care providers.
LPA reminded licensee of the following: Mandated Reporter certificate and CPR/First Aid certificate must be renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

LPA did not observe any bodies of water (other than the appropriately fenced and enclosed inground pool), hazardous materials, or toxins accessible to children on the premises during the inspection.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: PEREDA LOPEZ, ZAHAIRA
FACILITY NUMBER: 015700263
VISIT DATE: 10/30/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

No deficiencies were issued during today’s inspection. A copy of this report must remain of file for 3 years.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.

Exit interview conducted and report was reviewed with the licensee Zahaira Lopez Pereda.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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