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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421441
Report Date: 03/30/2022
Date Signed: 03/30/2022 03:57:44 PM

Document Has Been Signed on 03/30/2022 03:57 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:GALLEGOS, DEANNAFACILITY NUMBER:
013421441
ADMINISTRATOR:GALLEGOS, DEANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 294-9384
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
03/30/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:40 PM
MET WITH:Deanna GallegosTIME COMPLETED:
04:17 PM
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On 3/30/2022, Licensing Program Analyst (LPA) Jonathan Williams arrived at the facility unannounced for the purposes of conducting a Case Management inspection to verify correction of deficiencies. LPA was met by Licensee, Deanna Gallegos. Present for today's inspection are the Licensee, one fingerprint cleared and associated assistant provider, and six children in care (four preschoolers and two infants).

During visit conducted on 3/14/2022, the facility was found to be out of ratio. Type A deficiency was assessed. During today's inspection, the facility was found to be in ratio, with four preschool-aged children and two infants present in the facility. Deficiency is therefore cleared effective today. Ratio requirements were discussed in-depth for large Family Child Care Homes and Licensee stated that she understands and will adhere to the ratio requirements set forth in the California Code of Regulations.

Exit interview conducted. Appeal Rights provided.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2022
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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