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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410591
Report Date: 06/27/2024
Date Signed: 06/27/2024 10:31:19 AM

Document Has Been Signed on 06/27/2024 10:31 AM - 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ORCHARD, THEFACILITY NUMBER:
434410591
ADMINISTRATOR/
DIRECTOR:		PAMELA ERICKSONFACILITY TYPE:
850
ADDRESS:494 S. BERNARDO AVE.TELEPHONE:
(408) 789-2621
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 58TOTAL ENROLLED CHILDREN: 36CENSUS: 27DATE:
06/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Maria Roxanne ResumaTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Mel Matos met with Maria Roxanne Resuma, infant teacher, for an unannounced case management inspection. Purpose of today's inspection: provide an amended report for a case management investigation that was completed on June 27, 2024.

Exit interview conducted and report was reviewed with the infant director, Maria Roxanne Resuma. A Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2024
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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