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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393616496
Report Date: 06/20/2022
Date Signed: 06/20/2022 02:39:51 PM


Document Has Been Signed on 06/20/2022 02:39 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:AGUILAR, CRISTIANEFACILITY NUMBER:
393616496
ADMINISTRATOR:AGUILAR, CRISTIANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 594-3945
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:14CENSUS: 7DATE:
06/20/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Cristiane AguilarTIME COMPLETED:
03:00 PM
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On Monday, June 20th, 2022, at 12:45pm, Licensing Program Analysts (LPA),Elvira Sierra, conducted a POC (Plan of Corrections) inspection and met with Licensee, Cristiane Aguilar..Present in the facility was Licensee caing for seven children. LPA review staff files and are complete with Mandated Reporter Training Certificate and proof od current immunization.

Deficiencies issued on 05/12/22 have been cleared.

***No deficiencies cited against the facility under CCR,Title 22, Div. 12, Chapt. 1.***

A notice of site visit was given and must remain posted for 30 days. LPA posted the Notice of Site Visit on today’s inspection. Exit interview conducted and report was reviewed with the Licensee, Cristiane Aguilar.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:
DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/20/2022
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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