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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409748
Report Date: 02/07/2025
Date Signed: 02/07/2025 03:07:23 PM

Document Has Been Signed on 02/07/2025 03:07 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:LUGO REYES, LIZETHFACILITY NUMBER:
073409748
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/07/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Lizeth Lugo ReyesTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 02/07/2025 Licensing Program Analysts (LPAs) A. Hollinger and D. Campos arrived at the facility for an ANNOUNCED PRE-LICENSING INSPECTION and met with applicant, Lizeth Lugo Reyes. LPAs disclosed the purpose of the inspection and was granted entry into the facility by the applicant. Residing in the home is the applicant and three minor children. Present during the inspection was the applicant. There were no children present during this inspection. The facility was toured to conduct a health and safety inspection. The facility plans to operate Monday – Friday 7:00 AM- 5:00 PM.

This is a two story home which consists of three (3) bedrooms, one bathroom, living room, dining room, laundry room, kitchen, garage, basement, and backyard. The facility was observed to be neat and clean with heating and ventilation for the safety and comfort of children in care.

On-limit areas: The entire main floor and the bathroom located upstairs.

Off-limit areas: The 2 bedrooms located upstairs, the garage, basement, and a section of the backyard is blocked off and used for gardening. LPAs observed child-proof gates that have been installed at the top and bottom of the stairs. The off-limits areas are made inaccessible by closed/locked doors and child safety gates.

The outdoor play area is a fully fenced backyard. A portion of the backyard is blocked off for applicant's garden and is deemed off limits for children. The breezeway on the left will be made accessible for child pickup and the right side of the house is blocked off to prevent access by day care children. LPAs reminded applicant that 100% visual supervision will be required whenever children are present outside.

The Isolation area will be in the dining room away from other children in care.
See LIC809C--------------------------------------------------------------------------------------------------
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Hollinger
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2025
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 3
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: LUGO REYES, LIZETH
FACILITY NUMBER: 073409748
VISIT DATE: 02/07/2025
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There are ample age-appropriate toys that are observed to be safe, clean and in good repair. There are no bodies of water or pools accessible to children in care during today’s inspection. LPAs did not observe any hazardous materials or toxins accessible to children during today’s inspection. The home contains central heating and the heating vents are located on the floor which are not hot too the touch when heating is in use.

The home has a fully charged 2A10BC fire extinguisher and two first aid kits. There is a working smoke detector located in the living room and carbon monoxide detector located in the stair case which LPAs encouraged the applicant to conduct monthly tests on. The home has a working telephone. Per applicant there are no pets. Applicant states there are no firearms in the home. The applicant is in compliance with immunization laws which pertain to all childcare providers.

The applicant has completed the required mandated reporter training which expires 07/13/2026 and their CPR/Pediatric First Aid certificate expires 06/2026. Applicant was reminded that CPR/First Aid and mandated reporter training are to be renewed every two years. The roster of the children must be properly maintained, and a fire/disaster drill must be conducted and documented every six months. Baby bouncers & drop-down cribs are not allowed at the day-care facility. The applicant is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

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 which includes 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 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.

LPAs 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. See LIC809C--------------------------------------------------------------------------------------------------

SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Hollinger
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC809 (FAS) - (06/04)
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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: LUGO REYES, LIZETH
FACILITY NUMBER: 073409748
VISIT DATE: 02/07/2025
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On this date, 02/07/2025, 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.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. LPA 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.

The applicant provided proof of control of property.

The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC 9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6 children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 children.

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.

Exit interview conducted and report reviewed with the applicant, Lizeth Lugo Reyes.

SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Hollinger
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC809 (FAS) - (06/04)
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