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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136608025
Report Date: 10/23/2019
Date Signed: 10/23/2019 05:41:16 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:RCOE CALEXICO MIGRANT HEAD START CENTERFACILITY NUMBER:
136608025
ADMINISTRATOR:JUANA JUDITH FLORESFACILITY TYPE:
850
ADDRESS:1120 E. 7TH STREETTELEPHONE:
(760) 768-3500
CITY:CALEXICOSTATE: CAZIP CODE:
92231
CAPACITY:110CENSUS: 0DATE:
10/23/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:Jose MartinezTIME COMPLETED:
05:50 PM
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Licensing Program Analyst (LPA) Yolanda Baez arrived at the Main Office located at 370 Aurora Street, El Centro CA 92243 to conduct a case management inspection. Upon arrival LPA Baez met with Program Director, Jose Martinez.

The purpose of today's case management inspection is to review staff records for the staff that were present during the annual inspection that was conducted on 10/23/2019. The purpose of reviewing the staff files is to show compliance of staff's education, training, and/or experience, First Aid/CPR, SB792, and AB1207. All staff files are in compliance.

An annual continuation is required and will be conducted at the facility site.

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019
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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