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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700326
Report Date: 05/24/2023
Date Signed: 05/24/2023 01:34:43 PM

Document Has Been Signed on 05/24/2023 01:34 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:ALANIZ, GABRIELA & ROMERO CAMPOS, JORGEFACILITY NUMBER:
015700326
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
05/24/2023
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Gabriela AlanizTIME COMPLETED:
02:15 PM
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 Licensing Program Analyst (LPA) Sidney Cortez mer with licensee Gabriela Alaniz to conduct an inspection for increased capacity. Licensee operates the facility Monday through Friday from 6:00am until 6:00pm. Present for this visit is the licensee and 3 infants and her fingerprint cleared husband Jorge Romero-Campos.

The home is 1 story. The home consists of 4 bedrooms, 1 bathroom, living room, dining room, kitchen, backyard and garage. The home is neat and clean with heating and ventilation for safety and comfort. There is no pool or any type of bodies of water in the home.

The OFF LIMIT AREAS is the 3 bedrooms, storage on the backyard and the garage.
The ON LIMIT AREAS are the living room, dining room, family room, bathroom, and one bedroom and the backyard for play area. The ISOLATION AREA is the small bedroom that is on limits
There are toys and learning materials in the activity room area.
Hazardous materials and toxins are kept out of the reach of children.


The home has one fully charged fire extinguisher (model 2A10BC), and working smoke/carbon monoxide detectors, first aid kit, emergency supplies, and working telephone. Licensee’s CPR and First Aid certificates are current and both certificates will expire on April 2024. Licensee received a certificate in mandated reporter training on 3/3/2022 which is valid for 2 years.


The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on March 10, 2023. 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: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2023
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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