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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415518
Report Date: 08/26/2021
Date Signed: 08/26/2021 01:43:39 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:FUENTES CANO, ANAFACILITY NUMBER:
434415518
ADMINISTRATOR:FUENTES CANO, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 981-7161
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:14CENSUS: 0DATE:
08/26/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Ana Fuentes-CanoTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA), Janette Cruz, and Licensing Program Manager (LPM) Diana Stephenson, conducted a scheduled informal office meeting at the San Jose Regional Office with Ana Fuentes-Cano, Licensee. The purpose of today's meeting was to discuss staffing, ratio and capacity for a large Family Child Care Home.

The Facility was issued one "Type A" deficiency on July 28, 2021 Section 102416.5(f) - Staffing Ratio and Capacity - of Title 22 regulations as a result of not being in compliance with the ratio requirements for the large Family Child Care Home license. Based on record reviews and interviews, Licensee had at least 16 children present in her daycare during the month of May 2021.


LPM explained to the Licensee that if there are continued deficiencies cited for child ratio, the Facility may be referred to legal for possible administrative action, which could include revocation of the Facility license. The Facility will be monitored more frequently to ensure that the Facility is in compliance with the Department regulations.

On 7/29/21, The Licensee had submitted a written plan stating her understanding that she cannot exceed her license capacity. LPA and LPM reminded Licensee that she needs to be in compliance with her ratio and capacity requirements at all times.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette CruzTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021
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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