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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015701169
Report Date: 03/04/2025
Date Signed: 03/04/2025 11:57:19 AM

Document Has Been Signed on 03/04/2025 11:57 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 SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:CAMPOS GUZMAN, DAISYFACILITY NUMBER:
015701169
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
03/04/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:05 AM
MET WITH:Daisy Campos GuzmanTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 3/4/2025 at 10:05AM, Licensing Program Analyst (LPA) Jaleesa Jackson met with Licensee Daisy Campos Guzman for an Unannounced Licensee Initiated Case Management Visit. Licensee requested increasing capacity from 8 children to 14 children. Present during the inspection was the Licensee, 2 infants, and 2 preschool aged children. Licensee lives in the home with her minor daughter that is included in today's ratio. Licensee’s home was toured for a health and safety inspection. The facilities hours of operations are 7:30AM - 6:00PM, Monday - Friday.

ON LIMITS AREA: Living Room, Dining Room, Bathroom #1(downstairs bathroom), and Patio

OFF LIMITS AREA: Kitchen, Laundry Room, Entire upstairs (Bedroom #1, Bedroom #2, and Bathroom #2)

ISOLATION AREA: Reading Nook in Living Room

The facility is a 2 bedroom and 2 bathroom townhouse rented by the Licensee. The inside of the home is observed to be neat with age appropriate materials for the children. During today's visit all toxins, cleaning products, medications and hazardous materials were observed to be in inaccessible areas. All off limit areas in the home and made inaccessible with closed doors, safety gates, and locks. LPA did not observe any harmful bodies of water in or around the home. Licensee stated she has 1 small dog. Licensee stated there are no firearms in the home.

The home has gained a fire clearance on 2/6/2025 from the Fremont Fire Department with the condition of the second floor not to be used for childcare.



Continued on 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CAMPOS GUZMAN, DAISY
FACILITY NUMBER: 015701169
VISIT DATE: 03/04/2025
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The home has one (1) fully charged 3A40BC fire extinguisher in the kitchen. There is a working carbon monoxide detector and smoke alarm in the home. The home is equipped with central heat and air for proper ventilation. The Licensee’s Health and Safety training with the lead poisoning component has been completed and Pediatric CPR and First Aid certificates are current and expires on 11/2025. Mandated Reporter training is complete and expires on 11/22/2025.

All documents have been received for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

Increase of capacity has been approved 3/4/2025.


A notice of site visit was given and must remain posted for 30 days.

Appeal rights provided and discussed.

Exit interview conducted and report was reviewed with Licensee Daisy Campos Guzman.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025
LIC809 (FAS) - (06/04)
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