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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709802
Report Date: 07/15/2021
Date Signed: 07/15/2021 12:14:15 PM

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:OCHOA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
430709802
ADMINISTRATOR:PATRICIA KEITHFACILITY TYPE:
830
ADDRESS:902 ARIZONA CIRCLETELEPHONE:
(408) 842-2201
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY:12CENSUS: 0DATE:
07/15/2021
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
11:41 AM
MET WITH:Perlina ChavezTIME COMPLETED:
12:15 PM
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Licensing Program Analysts (LPAs) Samantha Yip and Aman Sharma conducted an unannounced Case Management- Annual Continuation inspection. LPAs met with Site Director Perlina Chavez and explained the reason for the inspection. The purpose of this inspection is to tour the inside of the facility.

Site Director stated that the infant room is currently closed. LPA reminded Site Director that any doors leading to the kitchen or storage room are locked. LPA also discussed with Site Director about the safe sleep regulation. LPA also discussed with Site Director about ensuring that the outdoor area is cleaned and any cobwebs are cleaned. Site Director stated that they power wash the area prior to the children starting.

As a result of this inspection, no deficiencies were cited. An exit interview was conducted where this report was discussed and provided to Site Director Perlina Chavez. A Notice of Site Visit has been issued and must be posted for 30 consecutive days.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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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