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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274450292
Report Date: 03/09/2020
Date Signed: 03/09/2020 10:52:43 AM

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:GODINEZ, MARIA TERESAFACILITY NUMBER:
274450292
ADMINISTRATOR:MARIA TERESA GODINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 753-1757
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY:14CENSUS: DATE:
03/09/2020
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Maria Teresa GodinezTIME COMPLETED:
10:50 AM
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Licensing Program Manager (LPM) Mary Segura and Licensing Program Analyst (LPA) Fermin Campos-Jaramillo met with Maria T Godinez, Licensee and her husband Jesus Godinez to explain the details of a letter sent to Licensee on March 02, 2020 in regards denying criminal records exemption to licensee's husband, Jesus Godinez.

LPA translated to licensee and her husband the details of the letter in Spanish and licensee stated she has understood the details.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2020
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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