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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406156
Report Date: 02/28/2024
Date Signed: 02/28/2024 10:30:28 AM

Document Has Been Signed on 02/28/2024 10:30 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SANDOVAL, VERONICAFACILITY NUMBER:
444406156
ADMINISTRATOR:VERONICA SANDOVALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 587-9289
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
02/28/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:57 AM
MET WITH:Veronica SandovalTIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Licensee, Veronica Sandoval, and explained purpose of visit- to conduct quarterly visit in response to probationary license requirements. Upon arrival, the Licensee was present with three (3) preschool-age children in care.

During tour of the home, LPA confirmed that all adults present have fingerprint clearances. Present in the home today were two of Veronica's adult children (S1 & S2). All conditions of the probationary license have been met during today's visit and LPA advised that continued quarterly visits will continue until 6/14/2025.

LPA advised Veronica that exemption request for S3 has ceased processing because no response was received to a request for information needed for a criminal record exemption. LPA additionally advised the case closure for the exemption request went into effect on 10/25/2023.

As a result of today's inspection, no deficiencies were cited.

Exit interview conducted and report was reviewed with the Licensee, Veronica Sandoval.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2024
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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