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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010213589
Report Date: 03/16/2022
Date Signed: 03/17/2022 01:44:03 PM

Document Has Been Signed on 03/17/2022 01:44 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:LOPEZ, BERNARDITA & DOMINGOFACILITY NUMBER:
010213589
ADMINISTRATOR:LOPEZ, BERNARDITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 888-9853
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 6DATE:
03/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:33 AM
MET WITH:BERNADITA LOPEZTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Sidney Cortez, and Licensing Program Manager (LPM) Wynn Norona arrived 09:18 AM and met with licensee BERNADITA LOPEZ for an UNANNOUNCED ANNUAL RANDOM INSPECTION. Present for this visit was the licensee BERNADITA LOPEZ, her fingerprinted cleared assistant ERIC LEE, and 6 kindergarten age childen. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:45AM until 5:00 PM, MONDAY-FRIDAY. The home is two story, which consists of living room,Dining room, Kitchen, (4) bedrooms, 3 bathrooms and garage and backyard play area.On Limit: living room, dining room, kitchen, bathroom downstairs and the outdoor play area, and the garage that is converted to a play area. The bathroom upstairs is used only for emergency. The off limit areas will be the 4 bedrooms, and the whole second story (visual supervision at all times). The isolation area will be the dining room area while others will be in the garage (play area).


The home is neat and clean with adequate ventilation for safety and comfort.
There are ample age appropriate toys and furnishings that are safe and in good repair. There are no pools, hot tubs or any other accessible bodies of water. There is a fully fenced outdoor yard and play area which is free from defects or dangerous conditions. There are ample age appropriate toys that are safe and appeared to be clean.. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible during today's inspection.The home has a fire extingisher 3A40BC (the last punch hole is 2020 by Fire Marshall) , working smoke detector, working carbon monoxide detector, working telephone. The licensee Health and Safety training is completed and CPR and First Aid certificates are current and expires in November 20, 2023. The licensee is in compliance with new immunization laws which pertain to day care providers. Per applicant, there are no firearms in the home. A copy of the mortgage statement was reviewed and shows control of property. The licensee's mandated reporter training is current and expires (March 4, 2024). Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on Dec 8, 2021. (4) Children files were reviewed, 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: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2022
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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