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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414303
Report Date: 02/10/2020
Date Signed: 02/10/2020 03:51:00 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:LECHUGA, ESTHERFACILITY NUMBER:
434414303
ADMINISTRATOR:LECHUGA, ESTHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 706-8930
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:13CENSUS: 0DATE:
02/10/2020
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:04 PM
MET WITH:Esther LechugaTIME COMPLETED:
03:55 PM
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Licensing Program Manager (LPM) Tony Studebaker and Licensing Program Analyst (LPA) Samantha Yip met with Licensee Esther Lechuga for a scheduled Informal Meeting at the San Jose Regional Office. The purpose of this meeting was to discuss the recent citation. Licensee was cited on 10/01/2019 for not having the required forms for enrolled children.

The citation is as followed:
Section 102421(a) Child's Record: The licensee shall maintain, in each child’s record...the signed and dated notice form LIC 995A: Parents Rights Notice, LIC 700: Identification and Emergency.

Licensee was previously cited for 01/05/2018 for not having the required forms for enrolled children. LPM discussed with Licensee how she will be in compliance in the future. LPM Studebaker provided Licensee with the LIC 311D Forms/Records to Keep in Your Family Child Care Home. LPM also discussed with Licensee about Technical Support Program.

LPM Studebaker explained the informal meeting and the administrative process. Licensee Esther was advised that continued non-compliance with Title 22 Regulations could result in their license being referred to CCL's legal department for review and possible action against the license. Assembly Bill 633 (Child Care Parent Notification Requirements) and Acknowledgement of Receipt of Licensing Reports (LIC9224) was also explained and provided to Licensee Esther Lechuga during today’s meeting.

Licensee Esther Lechuga understood that this department will increase monitoring of the facility for the next twelve months.

SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2020
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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