<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
434400316
Report Date:
10/25/2023
Date Signed:
10/25/2023 04:19:31 PM
Document Has Been Signed on
10/25/2023 04:19 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
,
2580 N FIRST STREET, STE. 300
SAN JOSE
,
CA
95131
FACILITY NAME:
LITTLE SONSHINE SCHOOLHOUSE
FACILITY NUMBER:
434400316
ADMINISTRATOR:
SULLIVAN, YOLANDA
FACILITY TYPE:
850
ADDRESS:
16970 DEWITT AVENUE
TELEPHONE:
(408) 779-6788
CITY:
MORGAN HILL
STATE:
CA
ZIP CODE:
95037
CAPACITY:
53
CENSUS:
13
DATE:
10/25/2023
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
02:55 PM
MET WITH:
Casie Piccardo
TIME COMPLETED:
03:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management-Other inspection. LPA met with Assistant Director Casie Piccardo and explained the reason for the inspection. The purpose of this inspection is to deliver the amended 809 report dated 10/12/2023 page 7 due to report and signature not saving.
No deficiencies were issued as a result of this inspection. Exit interview conducted and report was reviewed with Assistant Director Casie Piccardo. A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISOR'S NAME:
Joel Segura
TELEPHONE:
(408) 334-8550
LICENSING EVALUATOR NAME:
Samantha Yip
TELEPHONE:
(408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE:
10/25/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/25/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
1