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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073404604
Report Date: 09/06/2024
Date Signed: 09/06/2024 04:21:38 PM

Document Has Been Signed on 09/06/2024 04:21 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:MATUS, LINDAFACILITY NUMBER:
073404604
ADMINISTRATOR/
DIRECTOR:		MATUS, LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 216-1341
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
09/06/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:LINDA MATUSTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On September 6, 2024, Licensing Program Analyst (LPA) Tasha Alexander met with Licensee Linda Matus for an UNANNOUNCED CASE MANAGEMENT INSPECTION to re-active the family child care home license to active status.
Upon arrival, Present for today's inspection is licensee, her adult daughter Jackie, 3 grandchildren, ages 5 months, 18 months, 22 months and 1 infant day care child under 12 months. Residing in the home with licensee is her daughter Jacqueline and grand infant grand daughter (5 month old). The facility's hours of operation are 7:00am to 5:00pm, Monday through Friday. Ages cared for will be birth to school age.

The facility is a one story home, with 4 bedrooms, 2 bathrooms, living room, dinning room, kitchen, garage and backyard..
On limit areas: kitchen, dinning room, living room, nap room (1st bedroom on the right side), hall bathroom and backyard
Off limit areas: Remaining 3 bedrooms (daughter's bedroom), master bedroom/bathroom, 4th bedroom, garage
Isolation area: nap room (1st bedroom)

Today the following was inspected:
Mandated reporter certificate: unable to locate today bodies of water: none observed
guns/weapons: none per licensee licensee's immunization recs:
heating/air: central heat/air CPR & 1st aid: expired
fire place: blocked/inaccessible Fire extinguisher: 3A40BC fully charged
stairs: none Carbon Monoxide detector: working
smoke alarm: hardwired to fire dept- working

The license will be re-activated upon confirmation of : up to date mandated reporter certificate, up to date CPR & 1st aid cards and proof of immunizaitons (MMR,Pertussis & flu declaration).
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2024
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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