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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404552
Report Date: 12/20/2019
Date Signed: 12/20/2019 09:36:02 AM

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:ALVAREZ, GLORIAFACILITY NUMBER:
434404552
ADMINISTRATOR:ALVAREZ, GLORIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 729-4718
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:14CENSUS: 5DATE:
12/20/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Gloria AlvarezTIME COMPLETED:
09:45 AM
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LPA Deanna Villagrana met with licensee Gloria Alvarez for a case management visit. Present were licensee's assistant and four day care children. Licensee's son and another child arrived a short time later.

LPA observed on 12/19/2019 as she was leaving the home that licensee locked the door to the day care room not allowing the kids to enter the home. LPA explained she could not lock the door to detain children in the room. Licensee unlocked the door and stated she didn't want the children bothering LPA. LPA stated the children were not a problem.

LPA returned today 12/20/2019 to verify there was an emergency exit for children in the day care room. LPA observed a door that leads to an off limits living room that has a sliding door to outside side yard. LPA took pictures of day care room and off limits living room. LPA explained to licensee because there was an exit, no citation would be issued. Licensee apologized and stated she will no longer lock the door.

NO DEFICIENCIES CITED

NOTICE OF SITE VISIT WAS POSTED AND MUST REMAIN POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019
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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