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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444407201
Report Date: 07/18/2022
Date Signed: 07/18/2022 02:37:34 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/18/2022 02:37 PM - 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:CASTORENA, SUEMYFACILITY NUMBER:
444407201
ADMINISTRATOR:CASTORENA, SUEMYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 728-7738
CITY:FREEDOMSTATE: CAZIP CODE:
95019
CAPACITY:14CENSUS: 0DATE:
07/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Suemy Castorena TIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Elizabeth Larios met with Suemy Castorena, Licensee, for an unannounced Required – 1 year annual inspection. LPA was informed by Suemy that she has not been operating her day care since 2020. Suemy stated she will like to close her day care. LPA did not observe any children in care. Suemy provided LPA with a written statement of facility closer and surrender her licensee to LPA.

SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth LariosTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2022
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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