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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418935
Report Date: 03/12/2024
Date Signed: 03/12/2024 09:44:18 AM

Document Has Been Signed on 03/12/2024 09:44 AM - 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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:AMADO, MIRZA & URDIALES-AMADO, GIANELLYFACILITY NUMBER:
013418935
ADMINISTRATOR:AMADO, MIRZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 782-6235
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
03/12/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:27 AM
MET WITH:Mirza AmadoTIME COMPLETED:
11:35 AM
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Licensing Program Analyst Sidney Cortez, met with licensee Mirza Amado for an Unannouced Annual Random Inspection. Present for this visit was the licensee Mirza Amado. Present on this visit 3 ( 3 Preschool age children). The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:00AM until 6PM, MONDAY-FRIDAY. The home is one story which consists of a gated front yard, 4 bedrooms, 2 bathrooms, living room, kitchen, activity room, nap room and fence backyard. The home is centralized heating and ventilation for safety and comfort.
the On Limits areas of the family day-care are the activity room, the living room, dining room, kitchen, hallway bathroom, and the front yard area.
The Off-Limits areas are 4 bedrooms and the entire back yard, and they were inaccessible to children by closed doors and visual supervision. The home is clean, orderly with, heating and ventilation for safety and comfort. LPA’s observed and tested the smoke & carbon monoxide detectors.
The ISOLATION AREA will be the activity room. There are age appropriate toys that appear to be safe. There are no pools, hot tubs or any other bodies of water. All hazardous materials and toxins are kept out of the reach of children.
The home has a fully charged (3A40BC) fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee CPR and First Aid certificate is current and expires (March 2025). The licensee's mandated reporter training is valid until Jan 2026. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on
Jan 2024. 2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2024
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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