<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409488
Report Date: 03/13/2024
Date Signed: 03/13/2024 03:01:20 PM

Document Has Been Signed on 03/13/2024 03:01 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CUELLAR, GABRIELAFACILITY NUMBER:
073409488
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/13/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Gabriela CuellarTIME COMPLETED:
03:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On March 13, 2024 at 11:45am, Licensing Program Analysts (LPAs) Indira Loza and Janai McClain arrived at the facility for an announced prelicensing inspection. LPAs met with applicant Gabriela Cuellar. Living in the home are the applicant, her fingerprint cleared partner (Jose Figueroa), her minor son, and her pet dog, a Yorkie Teacup. The applicant plans to operate Monday-Friday 7:30am-5:30pm. LPAs verified the applicant's phone number and email on record are correct.

LPAs toured the home with the applicant, to conduct a health and safety inspection. LPAs observed that it is neat and clean with heating and ventilation for the safety and comfort of children. The home is two stories and the first floor consists of a living room, kitchen, dining room, office, bathroom, garage, and a backyard. The second level consists of three bedrooms and two bathrooms.

The Off Limit Areas are all three bedrooms, the two upstairs bathrooms, garage, backyard, stairs and dining room. The off limits areas are made inaccessible by gate, closed and/or locked doors and visual supervision.

The On Limit Areas are the kitchen, living room, downstairs bathroom, hallway near the front door, and driveway. The driveway is fenced and will be used as an outdoor play area.

Isolation Area - At the children's table in the kitchen

Inside the home the LPAs observed an ample supply of age appropriate toys, activities and equipment for children, which appeared to be safe and in good condition. The applicant stated that portable heaters will not be used while children are in care. LPAs did not observe any medication, bodies of water, hazardous items or poisons accessible to children during the inspection today. The applicant stated that chemicals will be stored in the garage.

****************************************************Page 1 of 4******************************************************

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CUELLAR, GABRIELA
FACILITY NUMBER: 073409488
VISIT DATE: 03/13/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
 The applicant stated there are no firearms in the home. The home is equipped with a fully charged 3A40BC fire extinguisher, working smoke detector and a working carbon monoxide detector. The applicant completed the preventative health and safety training which includes 1 hour of nutrition and lead component and the CPR and First Aid training which expires on September 2025. The Applicant has a current Mandated Reporter Certificate which expires on 09/20/2025. LPA reviewed all of the forms required for the children's files, facility file, posting and other information related to Licensing and the care of children. LPAs left copies with the applicant. LPAs advised the applicant of where to obtain additional copies of the forms. The applicant has the parent board next on the wall in the living room. The Licensee stated that the parents will be dropping off the children inside the home and will discourage parents from dropping off the children at the door. The applicant was reminded that she can move the parent board but it always has to remain in a prominent location where the parents can easily see the parent board. LPAs reminded the applicant that the required documents must be visible for the public at all times during hours of operation. A copy of the Entrance Checklist (LIC126) was provided to the applicant.

LPA reviewed children's personal rights and the applicant advised that she understands that children's personal rights should not be violated and no corporal punishment. LPAs reminded the applicant that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. LPAs reviewed fire/earthquake drill information, and how to complete the drill log. LPAs demonstrated how to fill out the immunization record for children's files, discussed the applicant's responsibility to ensure the records are up to date and have discussions with parents/guardians if they are not, and advised that it does not need to be done if children are enrolled in school. LPA reminded the applicant to report any injuries requiring medical attention or unusual incidents to the Oakland Regional Child Care office. LPAs reviewed the form to follow up in writing within 7 days of the injury/unusual incident. The applicant was encouraged to periodically review regulations, guidelines and PINS on the website www.ccld.ca.gov.

LPAs verified that the applicant, and all other adults living in the home, have a criminal record clearance and are associated to the license. Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial
*********************************************** Page 2 of 4 *************************************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CUELLAR, GABRIELA
FACILITY NUMBER: 073409488
VISIT DATE: 03/13/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPAs discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPAs also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

On March 13, 2024 the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at


*****************************************************Page 3 of 4******************************************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CUELLAR, GABRIELA
FACILITY NUMBER: 073409488
VISIT DATE: 03/13/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

The applicant provided proof of control of property.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

The License for a small family daycare will be granted, effective today, March 13, 2024.

Exit interview conducted.
Report reviewed and provided to Applicant Gabriela Cuellar.
****************************************************** Page 4 of 4 *****************************************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5