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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404530
Report Date: 06/15/2023
Date Signed: 06/15/2023 03:25:58 PM


Document Has Been Signed on 06/15/2023 03:25 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:LEPE, YOLANDAFACILITY NUMBER:
434404530
ADMINISTRATOR:LEPE, YOLANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 251-0435
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY:14CENSUS: 10DATE:
06/15/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:12 AM
MET WITH:Yolanda LepeTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA), Farida Raja and Licensing Program Manager (LPM), Gladys Kuizon, conducted an unannounced case management visit to follow-up on the Plans of Correction for deficiencies and obtain missing signatures on the report for facility inspection conducted on 05/26/2023. LPM and LPA were granted access to the home by Licensee, Yolanda Lepe at 10:12am and explained the nature of today's visit. Present in the home were Licensee, one staff and 10 children including 3 infants and 7 preschool age.
LPA confirmed that all deficiencies cited during the annual inspection conducted on 05/26/2023 were cleared. LPA provided Licensee with Cleared Plan of Correction Letters for all cleared citations.

Upon further review, Licensee was able to show that staff (S1) cited for background clearance was cleared and associated with this facility. LPA conducted further review on Community Care Licensing Guardian system and confirmed that said staff (S1) had obtained fingerprint clearance and is associated with this facility since 07/01/2021. As a result of this review the civil penalty in the amount of $100 cited on form LIC 421BG on 05/26/2023 will not be assessed.

As a result of today's inspection, there were no deficiencies cited.

Exit interview conducted and report was reviewed with the Licensee, Yolanda Lepe.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:
DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2023
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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