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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422792
Report Date: 01/13/2025
Date Signed: 01/13/2025 10:18:54 AM

Document Has Been Signed on 01/13/2025 10:18 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:LOPEZ, EMMAFACILITY NUMBER:
013422792
ADMINISTRATOR/
DIRECTOR:		LOPEZ, EMMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 287-6055
CITY:ALAMEDASTATE: CAZIP CODE:
94502
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
01/13/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:09 AM
MET WITH:Lopez,EmmaTIME VISIT/
INSPECTION COMPLETED:
10:26 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 1/13/25, at 9:09am, Licensing Program Analysts (LPAs) Mario Caro and Catherine Fernandes arrived unannounced on a Proof of Correction inspections regarding the recent type A citations given on 1/8/25. There were two preschoolers and three infants in care with an additional finger print cleared assistant.

On 1/8/25, three type A citations were given regarding ratio, accessible cleaning products and loose items in the crib. LPAs confirmed during today's inspection the Licensee is incompliance with ratio, has let go of three infants (children under the age of two), the accessible cleaning products are now latched inaccessible to children, and Licensee has confirmed nothing will be placed in the cribs during nap time.

Licensee has also provided proof of signed Acknowledgement of Receipt of Licensing Reports (LIC9224), which has been signed by all enrolled parents in the child care home.


Exit interview conducted with Licensee Lopez
Report, Notice of Site of Visit and Appeal Rights provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2025
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 1