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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420728
Report Date: 06/07/2024
Date Signed: 06/07/2024 10:26:50 AM

Document Has Been Signed on 06/07/2024 10:26 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:INIGUEZ, JOSEFACILITY NUMBER:
013420728
ADMINISTRATOR/
DIRECTOR:		INIGUEZ, JOSEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 967-0219
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 12DATE:
06/07/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Jose IniguezTIME VISIT/
INSPECTION COMPLETED:
10:40 AM
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 June 7, 2024 at 8:50 AM Licensing Program Analyst (LPA) Janai McClain met with Licensee Jose Iniguez for the purpose of conducting an unannounced Plan of Correction (POC) visit. Present during today's inspection were two fingerprint cleared assistants, Leslie Gomez and Iris Sanchez, four infants, and eight preschool age children. LPA conducted a tour for a health and safety check.

On June 5, 2024 the Licensee was cited on HSC 1596.871(c)(1)(A) for having two non-fingerprint cleared assistants present. The Licensee had two fingerprint cleared assistants present today. Therefore, the citation has been cleared.

There were no deficiencies issued during todays visit.
Report and appeal rights reviewed and provided to Licensee Jose Iniguez.
Notice of Site Visit provided and must remain posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Janai McClain
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2024
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 1