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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073403878
Report Date: 01/16/2020
Date Signed: 01/16/2020 09:08:38 AM

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:JUSTO, GISELLFACILITY NUMBER:
073403878
ADMINISTRATOR:JUSTO, GISELLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 860-8543
CITY:EL CERRITOSTATE: CAZIP CODE:
94530
CAPACITY:14CENSUS: 8DATE:
01/16/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Gisell JustoTIME COMPLETED:
09:15 AM
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On 01/16/2020, Licensing Program Analyst (LPA), Melissa Guirit met with licensee, Gisell Justo for an unannounced POC inspection. Present for this inspection were licensee, fingerprint cleared assistant, Karen, two infants, and six preschoolers. The reason for today's inspection was to clear the Type A deficiency of facility being over capacity. During today's inspection, licensee is in ratio. LPA provided ratio picture guide to licensee to refer to when she needs to.

There are no deficiencies cited. This report shall remain on file for 3 years. Notice of Site of Site Visit was given. Exit interview conducted and appeal rights provided.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Melissa GuiritTELEPHONE: (510) 622-2624
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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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