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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004316
Report Date: 09/15/2020
Date Signed: 09/16/2020 10:48:47 AM

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:BAQUERO, ANGELA V.FACILITY NUMBER:
384004316
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
09/15/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jose B. CamargoTIME COMPLETED:
10:00 AM
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LPA Yee conducted a teleconference with Angela's husband, Jose today. Applicant, Angela speaks limited English. Jose translates the information to Angela from English to Spanish.

Today, the following information has been corrected.

1) red tape indicator is taped on steps near the entry to prevent children from tripping
2) all sharp edges on the walls in the daycare room have been cushioned.
3) gate leading to the upper level has been installed.
4) stairs that leading from the patio to the backyard has been installed.


A small FCCH license is approved effective today, 9/15/2020.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2020
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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