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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274450228
Report Date: 05/05/2022
Date Signed: 05/05/2022 04:02:55 PM


Document Has Been Signed on 05/05/2022 04:02 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:GREAT BEGINNINGSFACILITY NUMBER:
274450228
ADMINISTRATOR:ELVIA ZAMORAFACILITY TYPE:
850
ADDRESS:52 SOLEDAD DRIVETELEPHONE:
(831) 647-0551
CITY:MONTEREYSTATE: CAZIP CODE:
93940
CAPACITY:57CENSUS: 41DATE:
05/05/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:16 PM
MET WITH:Jillian AndradeTIME COMPLETED:
04:05 PM
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Licensing Program Analyst (LPA), Joe Macias, conducted an unannounced case management inspection in response to an unusual incident that the facility self reported to Community Care Licensing (CCL) on March 30, 2022. LPA met with the Director Jillian Andrade and explained the nature of today's inspection. LPA interviewed staff during to today's visit.

This inspection was made to obtain additional information about an unusual incident that occurred on Wednesday March 30, 2022. Assistant Director Jillian Andrade called in the unusual incident the same day it occurred.

During today's inspection LPA Macias interviewed staff, and obtained copies of pertinent information.


No deficiencies cited, exit interview conducted, and a copy of this report was provided to the facility.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE CENTER, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:
DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/05/2022
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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