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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 350709612
Report Date: 07/29/2024
Date Signed: 07/29/2024 12:13:12 PM


Document Has Been Signed on 07/29/2024 12:13 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:HOLLISTER HEAD STARTFACILITY NUMBER:
350709612
ADMINISTRATOR:ROCIO LITLEFACILITY TYPE:
850
ADDRESS:1011 LINE STREETTELEPHONE:
(408) 637-8597
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:77CENSUS: 11DATE:
07/29/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Rocio LitleTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Elizabeth Larios met with Site Director, Rocio Litle, for a Case Management visit. Site Director self reported an alleged incident on July 24, 2024 involving day care child (C1) and day care child (C2). During the investigation process, LPA toured the facility, conducted interviews, and obtained copies of documents.

Based on the information gathered during the investigation, there is no evidence to prove that children's personal rights were violated.

There were no deficiencies cited. Exit interview was conducted, where this report was reviewed and discussed with Site Director, Rocio Litle.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth LariosTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2024
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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