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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434405203
Report Date: 08/23/2019
Date Signed: 08/23/2019 03:00:53 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:GARCIA, RAMONAFACILITY NUMBER:
434405203
ADMINISTRATOR:GARCIA, RAMONAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 972-5610
CITY:SAN JOSESTATE: CAZIP CODE:
95111
CAPACITY:14CENSUS: 8DATE:
08/23/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Ramona GarciaTIME COMPLETED:
03:05 PM
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LPA Janet Tse met with licensee Ramona Garcia for a Plan of Correction inspection. LPA explained the nature of today's visit to Licensee. LPA observed eight children including four infants with Licensee and her daughter who is also her assistant (YG) in the home. The Family Child Care Home is operating within ratio and capacity today.

LPA observed the notice of site visit and the report with type A deficiency cited were posted. LPA reviewed children's files and observed LIC 9224 Acknowledgement of Receipt of Licensing Report for the report and the type A deficiency issued on 08/14/2019 are in file with parents' signatures, except for two children who are on vacation and have not returned to the child care home yet.

No deficiency was cited. Notice of site visit was issued and must be posted for 30 days.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet TseTELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2019
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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