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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409133
Report Date: 10/13/2023
Date Signed: 10/13/2023 02:19:27 PM

Document Has Been Signed on 10/13/2023 02:19 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:CABRERA BALMORI, SOFIAFACILITY NUMBER:
073409133
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 9DATE:
10/13/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:21 PM
MET WITH:Sofia Cabrera BalmoriTIME COMPLETED:
02:29 PM
NARRATIVE
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On October 13, 2023 at 1:21pm Licensing Program Analyst (LPA) Indira Loza met with Licensee Sofia Cabrera Balmori for the purpose of conducting a Case Management - POC visit. Present during today's inspection were the Licensee, her fingerprint cleared mother/assistant, 7 preschool age children, one infant, and one school-age child.

The Licensee was cited on 9/29/23 for having 9 children in care during the visit. The POC was to only care for a maximum of 8 children. The Licensee failed to correct the violation and had 9 children in care during today's visit. The Licensee will be issued a Civil Penalty for failure to correct and a Type A violation for ratio. One child left the daycare at approximately 2pm bringing the facility into compliance during the visit.

See LIC809-D for deficiency.

Exit interview conducted.
Report and Appeal Rights reviewed and provided to Licensee Sofia Cabrera Balmori.
Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2023
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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Document Has Been Signed on 10/13/2023 02:19 PM - It Cannot Be Edited


Created By: Indira Loza On 10/13/2023 at 01:58 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CABRERA BALMORI, SOFIA
FACILITY NUMBER: 073409133

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/16/2023
Section Cited
CCR
102416.5(c)

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(c) The total licensed capacity for a Small Family Child Care Home shall not exceed eight children.

This requirement is not met as evidenced by:
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The Licensee shall ensure to always maintain the ratio at 8 children or less during operation hours, LPA will return to the faiclity to verify that the licensee if complying with the regulation.
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Based on observation, the licensee did not comply with the section cited above as there were 9 children in care during the first half hour of the visit which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mayla Mendoza
LICENSING EVALUATOR NAME:Indira Loza
LICENSING EVALUATOR SIGNATURE:
DATE: 10/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/13/2023


LIC809 (FAS) - (06/04)
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