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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000854
Report Date: 01/19/2022
Date Signed: 01/19/2022 01:29:44 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SUAREZ, DELIA MARGARITAFACILITY NUMBER:
384000854
ADMINISTRATOR:SUAREZ, DELIA MARGARITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 516-3272
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY:14CENSUS: 0DATE:
01/19/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Delia SuarezTIME COMPLETED:
10:10 AM
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Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced Plan of Correction (POC) inspection. LPA met with Licensee, Delia Suarez and explained purpose of inspection. No children were in care. Licensee stated that facility is closed.

On 01/11//22, the following deficiency was cited during a complaint investigation. Facility did not comply with Title 22 Regulations, Section 102416.5(d)(1). Facility was over capacity by one infant child.

Deficiencies cited on 1/19/22 were cleared today.

During today's inspection (1/10/22), LPA received a children's roster.

No citations were cited today under Tittle 22 regulations.

An Notice of Site Visit shall be posted in a prominent place in facility for 30 days. Failure to maintain posting as required will result in a civil penalty of $100.

Report was emailed to licensee, Delia Suarez. Signed copy of this report will be kept in the facility file and made available for public review. Desk Duty is available Monday through Friday between 8:00 AM - 5:00 PM at (650) 266-8800. Website for forms and Regulations: www.cdss.ca.gov
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 350-2554
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2022
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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