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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407727
Report Date: 10/01/2019
Date Signed: 10/04/2019 08:10:12 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:QUINTANA, REBECAFACILITY NUMBER:
073407727
ADMINISTRATOR:QUINTANA, REBECAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 962-1787
CITY:EL CERRITOSTATE: CAZIP CODE:
94530
CAPACITY:14CENSUS: 12DATE:
10/01/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Rebeca QuintanaTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced case management site inspection for this facility at 1450. LPA met with licensee, Rebeca Quintana. There were 12 preschool age children in care along with two assistants. The facility is within ratio and capacity.

Licensee recently returned from a family trip and has resumed providing child care. LPA and licensee discussed possible times/dates for an office meeting. LPA will follow up with licensee with a definite date/time.

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

DATE: 10/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019
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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