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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073403811
Report Date: 01/12/2024
Date Signed: 01/12/2024 03:16:47 PM

Document Has Been Signed on 01/12/2024 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:LEE-OLORTEGUI, SILVIAFACILITY NUMBER:
073403811
ADMINISTRATOR:LEE-OLORTEGUI, SILVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 288-1956
CITY:CONCORDSTATE: CAZIP CODE:
94519
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
01/12/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Silvia Lee-OlorteguiTIME COMPLETED:
03:30 PM
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On 01/12/2024 at 11:44 AM licensing program analysts (LPA) Sikia Blue and Christina Watts conducted an unannounced case management inspection. LPA met with licensee Silvia Lee-Olortegui explained the purpose of today’s visit to follow up on a self-reported unusual incident. Present in the home is licensee, aid, licensee husband, 3 infants, and 2 preschoolers. LPA toured the home, made observations, and conducted interviews. At this time, there were no compliance issues during today visit and no deficiencies are being cited today.

Exit interview conducted, appeal rights were given, and report was reviewed with the licensee Silvia Lee-Olortegui.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2024
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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