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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406809
Report Date: 06/11/2019
Date Signed: 06/11/2019 09:52:47 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:ORUCUTA, JUANAFACILITY NUMBER:
073406809
ADMINISTRATOR:ORUCUTA, JUANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 898-1476
CITY:EL CERRITOSTATE: CAZIP CODE:
94530
CAPACITY:14CENSUS: 10DATE:
06/11/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Juana OrucutaTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced Plan of Correction site inspection for this facility on 06/11/19 at 0905. LPA met with licensee, Juana Orucuta. Also present were ten children in care consisting of four infants and six preschool age children and licensee's daughter, Lesly Arellano. LPA reviewed the children's records and verified that the facility has a fully charged fire extinguisher and carbon monoxide detector present. All POCs have been corrected.

There were no deficiencies cited during this inspection. A notice of site visit was issued and is to be posted for a period of 30 days. A copy of this report is to remain in the facility record for three years.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2019
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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