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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274404043
Report Date: 06/10/2022
Date Signed: 06/10/2022 10:06:18 AM

Document Has Been Signed on 06/10/2022 10:06 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:PONCE, MARIAFACILITY NUMBER:
274404043
ADMINISTRATOR:PONCE, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 262-7488
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
06/10/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Maria PonceTIME COMPLETED:
10:10 AM
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On 06/10/2022 at 09:25 AM, Licensing Program Analyst (LPA) Susy Cervantes, met with licensee Maria Ponce, for a case management visit to inspect the wall heater cover and informed them of the reason for the visit. Present were licensee and their spouse/assistant with seven children in care: 4 infants, 2 preschool, and 1 school age.

Facility had an annual inspection on 02/09/2022 and there were no deficiencies. LPA observed the wall heater where the infants nap has been covered and is secured to the wall, LPA took pictures of the secured wall heater.

No deficiencies were cited during today's visit. Exit interview conducted and report was reviewed with the licensee Maria Ponce. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE: DATE: 06/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/10/2022
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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