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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015701123
Report Date: 05/30/2024
Date Signed: 05/30/2024 02:17:16 PM

Document Has Been Signed on 05/30/2024 02:17 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:MANCIA, NELLYFACILITY NUMBER:
015701123
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/30/2024
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:47 PM
MET WITH:Nelly ManciaTIME VISIT/
INSPECTION COMPLETED:
03:12 PM
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Licensing Program Analyst Sidney Cortez, conducted a Change of Location Inspection. Present for this visit was the licensee Nelly Mancia. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 6:30AM until 6PM, MONDAY-FRIDAY. This is a one story house which consists of a living room/dining room, one bathroom,3 bedrooms,kitchen, and backyard. The home is neat and clean, with screened wall heaters. LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during today's inspection. On-limit-areas include: Living room/dining room, nap room (1 bedroom), and backyard. Isolation Area: will be in the living room away from children in care.The Off-Limit areas include: the kitchen, 2 bedrooms, and garage –which will be inaccessible by child safety gates, and visual supervision.

There are ample age appropriate toys, learning materials, and equipment that appear to be safe and in good condition. The home has a working smoke detector, carbon monoxide detector, working telephone, and First Aid Kit. The on limit patio is fenced and free from defects or dangerous conditions.
The home has a fully charged (2A10BC) fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone.

The licensee CPR and First Aid certificate is current and expires (March 2026). The licensee's mandated reporter training is complete and she received a certification of completion on
March 2024. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on MAY 1, 2024. All REQUIRED forms are posted and visible for public review. This change of location is recommended for licensing.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/30/2024
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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