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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408601
Report Date: 11/09/2023
Date Signed: 11/09/2023 10:17:36 AM

Document Has Been Signed on 11/09/2023 10:17 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:RAMIREZ, MAYRAFACILITY NUMBER:
073408601
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/09/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:31 AM
MET WITH:Mayra RamirezTIME COMPLETED:
10:25 AM
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On November 9, 2023 at 8:31am Licensing Program Analyst (LPA) Catherine Fernandes met with Licensee Mayra Ramirez for an increase in capacity inspection. Present for today’s inspection was the licensee, residing in the home is the Licensee's fingerprint cleared Husband, and three underage children. Operating days and times are Monday through Thursday 7:00am-4:30pm.

ON LIMIT AREAS: Living Room, Dining Room, the first bedrooms on the right and left of the hallway, and the bathroom at the end of the hallway and the fenced in backyard.

OFF LIMIT AREAS: The third and fourth bedroom at the end of the hallway, the bathroom attached to the master bedroom, and the garage. The off-limit areas will be inaccessible by child gates, closed and/or locked doors and adult supervision.

ISOLATION AREA is in the living room.

The home recently completed a required one year inspection on 7/21/23, while at the home LPA Fernandes observed a disaster drill log and missing immunizations. LPA did a walk through of the home and observed a pull down fire alarm near the front door, a working smoke/carbon monoxide detector throughout the home and a 3A40BC fire extinguisher in the kitchen under the sink.

On 08/23/23, a fire clearance was granted to facility #073408601 by Contra Costa County Fire Protection Department. All documents have been reviewed 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.


As of 11/9/23 the home has been approved to operate as a large family day care license.

See 809C

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: RAMIREZ, MAYRA
FACILITY NUMBER: 073408601
VISIT DATE: 11/09/2023
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Exit interview conducted with licensee

Report, Appeal Rights and Notice of site visit provided.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
LIC809 (FAS) - (06/04)
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