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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421553
Report Date: 01/30/2024
Date Signed: 01/30/2024 05:41:49 PM

Document Has Been Signed on 01/30/2024 05:41 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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:DELGADO, MARSEILLEFACILITY NUMBER:
013421553
ADMINISTRATOR:DELGADO, MARSEILLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 695-8523
CITY:SAN LORENZOSTATE: CAZIP CODE:
94580
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
01/30/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Marseille DelgadoTIME COMPLETED:
03:06 PM
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Licensing Program Analyst Sidney Cortez, met with licensee Marseille Delgado for an Unannouced Annual Random Inspection. Present for this visit was the licensee Marseille Delgado, her fingerprinted assistants: Vanessa Marquez. Present are 3 Preschool age children, and 3 school age children (Total of 6 children). The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 6:00AM until 6:30PM, MONDAY-FRIDAY. The home is a single family home. 3 Bedrooms and 2 bathrooms, living room, dining area, kitchen, and backyard. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the living room, the hall bathroom, the first and second bedrooms located on the left side of the hallway, the kitchen and dining area, the family room, and the backyard The OFF LIMIT AREAS are are the master bedroom, the room on the right side of the hallway, and the garage which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be the first bedroom located on the left side of the hallway. 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. Per licensee, there are no firearms in the home.


The home has a working smoke detector, carbon monoxide detector, working telephone, and First Aid Kit. 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 (December 2024).. The licensee's mandated reporter training is current and expires (January, 2025). 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 Dec 2023.


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: 01/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2024
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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