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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444411913
Report Date: 03/05/2020
Date Signed: 03/05/2020 10:30:47 AM

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:ARREOLA-FLORES, MARIANAFACILITY NUMBER:
444411913
ADMINISTRATOR:ARREOLA-FLORES, MARIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 431-0490
CITY:SANTA CRUZSTATE: CAZIP CODE:
95062
CAPACITY:14CENSUS: 9DATE:
03/05/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Janessa Leos Cruz and Mariana Arreola-FloresTIME COMPLETED:
10:35 AM
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Plan of Correction (POC) inspection. Upon arrival, LPA met with Janessa Leos Cruz and explained the reason for the visit. There were 2 assistants and 9 children, whom 1 was infant age . Licensee Mariana Arreola-Flores arrived at 10:16AM

The reason for the inspection was License was cited on 02/12/2020 under Section 102417(g)(9)(A) for not conducting a fire/disaster drill every 6 month. During today's inspection, LPA reviewed fire/disaster log. The last fire/disaster drill was conducted on 02/17/2020. Deficiency cited on 02/12/2020 has been cleared. A Cleared POC letter was provided to Licensee during today's inspection.

No deficiencies have been cited as a result of this inspection. An exit interview was conducted where this report was discussed and provided to Licensee Mariana Arreola-Flores. A Notice of Site Visit has been issued and must be posted for 30 consecutive days.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
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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