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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408402
Report Date: 12/13/2019
Date Signed: 12/13/2019 04:14:19 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:PITT, GLADYSFACILITY NUMBER:
434408402
ADMINISTRATOR:PITT, GLADYSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 985-1012
CITY:SANTA CLARASTATE: CAZIP CODE:
95050
CAPACITY:14CENSUS: 5DATE:
12/13/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Gladys PittTIME COMPLETED:
04:25 PM
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Licensing Program Analyst (LPA) conducted an unannounced site visit to the day care home for a case management. LPA met with Licensee Gladys Pitt and explained to her the purpose of the inspection. Present were five children in care of whom one was under two years old

The backyard and room adjacent to the Kitchen is currently under renovation. Licensee is also fixing the front porch of her day care home. Licensee stated that the renovation is expected to be complete at the end of January 2020. LPA remind Licensee to ensure that hazardous materials such as toxic, cleaning compounds, construction tools, etc. are kept inaccessible to the children. Also, Licensee stated that she will provide on-site supervision at all times when she takes the children to the front yard area of the home.

Exit interview was conducted, where this report was reviewed with Licensee.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN ENTRANCE INTO THE HOUSE FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
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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