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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700345
Report Date: 09/07/2023
Date Signed: 09/07/2023 02:01:08 PM

Document Has Been Signed on 09/07/2023 02:01 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:YEPEZ, DANIELFACILITY NUMBER:
015700345
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
09/07/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:34 PM
MET WITH:Daniel YepezTIME COMPLETED:
02:45 PM
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On Sept 7, 2023 LPA Cortez conducted a case management visit for the licensee Daniel Yepez.
Licensee requested technical assistance regarding increase of capacity. He wants to make sure that certain physical plants are within regulation. Present are 2 pre school age children, his fingerprint cleared assistant: Blanca Castorena and the licensee.

Licensee was advised that it will be the Fire Department that will issue a fire clearance. As soon as he gets the fire clearance we can continue the process of increase of capacity.

Licensee was reminded that First Aid CPR and Mandated Reporter are due every 2 years. And that Fire and Earthquake drill must be done every 6 months.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2023
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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