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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004279
Report Date: 03/02/2022
Date Signed: 03/02/2022 06:59:05 PM


Document Has Been Signed on 03/02/2022 06:59 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:ROCHA, BARBARA M.FACILITY NUMBER:
414004279
ADMINISTRATOR:ROCHA, BARBARA M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 712-9799
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY:14CENSUS: 6DATE:
03/02/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Barbara RochaTIME COMPLETED:
12:00 PM
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On March 2nd, 2022 at 10:55am, Licensing Program Analyst (LPA) Tapia-Mandujano met with licensee, Barbara Rocha. conducted a Plan of Correction (POC) inspection. Purpose of inspection was explained and was an unannounced, plan of correction inspection. Present in the facility are Licensee and two assistants caring for 6 children (4 infants and 2 preschool age). All adults living and working in the facility are fingerprint cleared and associated. LPA inspected for Health and Safety Hazards.

On 2/25/2022, licensee was cited under Tittle 22 Division 12 CCR:102416.5(d)(1), as facility was operating over capacity. Licensee had 5 infant children present.

During today's inspection, LPA observed that there are only four infants present. LPA obtained a copy of Children's Roster and copy of Scheduled Infants Plan.

Deficiency issued on 2/25/2022, was cleared and ‘Cleared Plan of Correction Letter’ was provided to Licensee.

Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview was discussed with Licensee, Barbara Rocha.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Facility was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2022
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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