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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423724
Report Date: 02/09/2023
Date Signed: 02/09/2023 02:20:47 PM

Document Has Been Signed on 02/09/2023 02:20 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CAMBEROS,L., CASTRO, G., & ESQUIVEL, A.FACILITY NUMBER:
013423724
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
02/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:L. Camberos, G. Castro, A. Esquivel, M. CastroTIME COMPLETED:
09:15 AM
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Licensing Program Analyst Lisa Dyer conducted an announced pre-licensing inspection. Present were the applicants Laura Camberos, Gerardo Castor and Angela Esquivel. Also present was Monzerrat Castro, who translated.

This is the second inspection for this location. At the time of the first inspection, dated 01/26/23, it was requested that the applicants complete the following 3 items to prepare the home to be licensed:

1. Remove the washer and dryer on the side of the home.
2. Move toy in day care area next to heater.
3. Block storage area under back stairwell (plastic fence, safety fence, furniture, etc).

A review of the items listed above has been completed. The applicants have:

1. Removed the washer and dryer on the side of the home.
2. Moved the toy in day care area next to heater.
3. Blocked storage area under the back stairwell.

It is recommended that a license be issued to this Family Day Care Home pending receipt of all final clearances and the completion of all requirements. A license will be processed as soon as administratively possible.

Exit interview conducted.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2023
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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