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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407813
Report Date: 10/05/2023
Date Signed: 10/05/2023 12:34:01 PM

Document Has Been Signed on 10/05/2023 12:34 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:PEREZ, SILVIAFACILITY NUMBER:
073407813
ADMINISTRATOR:PEREZ, SILVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 566-6005
CITY:RICHMONDSTATE: CAZIP CODE:
94804
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 7DATE:
10/05/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Silvia PerezTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced Plan of Correction (POC) inspection. LPA met with licensee, Silvia Perez. During today's inspection there were 4 infants and 3 preschool aged children in care.

Licensee was cited on 9/26/23 for operating out of ratio. Licensee was given a plan of correction to come into compliance with the required ratio by close of business of 9/26/23. 9/27/23 LPA conducted a follow up inspection. During the inspection on 9/27/23 licensee remained out of compliance, licensee had 8 infants and 3 preschool aged children in care.

On 9/26/23 licensee was also cited for not having a written emergency disaster plan.

During today's inspection licensee is operating within the capacity limits and ratio stated on the license.
During today's inspection, licensee provided a copy of the written Emergency Disaster Plan to LPA.
All citations issued during annual inspection on 9/26/23 have been cleared.

Exit interview and report reviewed with Silvia Perez.
Notice of Site visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2023
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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