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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418370
Report Date: 01/31/2025
Date Signed: 01/31/2025 06:45:29 PM

Document Has Been Signed on 01/31/2025 06:45 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:GALLARDO, ADRIANAFACILITY NUMBER:
013418370
ADMINISTRATOR/
DIRECTOR:		GALLARDO, ADRIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 938-7886
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
01/31/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Adriana GallardoTIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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On January 31st, 2025 at approximately 9:05am, Licensing Program Analyst (LPA) April Wright met with licensee Adriana Gallardo for an Annual Random Inspection. There were two (2) preschool age children present during inspection. LPA toured the facility to conduct a health and safety inspection. Licensee is in ratio today. Hours of operation are 8:30am - 5:30pm Monday through Friday.

The home is a single-story home with three (3) bedrooms and two (2) bathrooms, a living room, family room, kitchen, attached 2-car garage, front, side and back yard. Licensee uses ADU (Additional Dwelling Unit) on the left side of the garage for day-care operations. ADU consists of 2 rooms with kitchenette, bathroom and small side play yard. ADU has a gated entrance which is to the left of the garage. ADU was neat and orderly, with heating and ventilation for safety and comfort of children in care. There are age appropriate toys that appear to be safe and in good condition. LPA observed and licensee confirmed that there are no hazardous materials, including cleaning products or toxins present during the inspection. All items are made inaccessible to children in care. LPA observed and Licensee confirmed that are no weapons or firearms present at the home.

On-limit-areas include: The ADU two (2) rooms, kitchenette, bathroom, the small enclosed side yard. Main residence family/TV room with Licensee supervision for use when inclement weather prevents outside play in side yard. Backyard is used occasionally when park located across from the home is closed. LPA observed and Licensee confirmed that there are no pets, no pools, hot tubs, bodies of water in the home.

Off-limit-areas include: Main residence with all three (3) bedrooms and two (2) bathrooms, living room, kitchen and attached 2-car garage. The off limits are and will be made inaccessible by closed and/or locked doors and visual supervision.

See LIC809C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2025
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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: GALLARDO, ADRIANA
FACILITY NUMBER: 013418370
VISIT DATE: 01/31/2025
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All individuals subject to criminal record review have a clearance or exemption and have been associated to this FCCH. LPA requested and reviewed the files of two (2) children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. Fire and disaster drills are conducted every 6 months and the last was conducted on 9/12/2024. The licensee has a current CPR/First aid training which expires on 2/2026 and Mandated Reporter training was completed on 11/10/2023. The licensee is in ratio today. All required forms are posted and visible for public review. Licensee was reminded that training certificates must be renewed every 2 years.

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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.



Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP . When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and ADA, available at: https://www.ada.gov/resources/child-care-centers/.

See LIC809C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: GALLARDO, ADRIANA
FACILITY NUMBER: 013418370
VISIT DATE: 01/31/2025
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee Gallardo, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days. Report was read and reviewed with licensee Adriana Gallardo.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
LIC809 (FAS) - (06/04)
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