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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274407058
Report Date: 04/01/2026
Date Signed: 04/01/2026 12:58:45 PM

Document Has Been Signed on 04/01/2026 12:58 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SAAVEDRA, ARACELIFACILITY NUMBER:
274407058
ADMINISTRATOR/
DIRECTOR:		SAAVEDRA, ARACELIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 633-0598
CITY:CASTROVILLESTATE: CAZIP CODE:
95012
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
04/01/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Aaraceli SaavedraTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
NARRATIVE
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On 04/01/2026, Licensing Program Analysts (LPAs), Farida Raja and Diana De Leon, conducted an unannounced case management inspection. LPAs met with Licensee, Araceli Saavedra and explained the nature of today's visit to her. LPA De Leon translated the conversation during today's inspection. Upon entry, LPAs observed Licensee and two preschool children in the home. Present during the inspection were Licensee and three adults (S2-S4). Per Licensee, 7 adults including Licensee and one minor child currently reside in the home.

Purpose of today's inspection is to verify that individual, S5 who does not have fingerprint clearance, is not a resident at this facility. Licensee stated that S5 is her son-in-law and has been residing at the home since end of last year. LPAs toured the on limit areas and interviewed the Licensee and daughter (S4). Licensee and daughter stated that they completed fingerprints for S5 as required and received a letter and assumed that the individual is cleared. Licensee stated that she has not received any other communication after that. LPAs did not see individual, S5 in the home during the visit today.

LPAs reminded Licensee that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPAs informed Licensee that S5 has not obtained fingerprint clearance and must obtain clearance prior to residing in the home. LPA reminded Licensee to check with the Department to ensure that fingerprinted individuals are cleared prior to residing or working at the facility. During the facility walk through LPAs observed that the on limit bathroom to children is under construction. Licensee stated that they had a water leak and children are currently using the off limit master bathroom.

Continued on Page 2

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/01/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/01/2026 12:58 PM - It Cannot Be Edited


Created By: Farida Raja On 04/01/2026 at 11:08 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAAVEDRA, ARACELI
FACILITY NUMBER: 274407058

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/01/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/02/2026
Section Cited
CCR
102370(d)(1)

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(d) All individuals subject to a criminal record review... shall prior to working, residing or volunteering in a licensed facility:(1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by:
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Licensee to submit a written plan of correction to LPA by plan of correction due date of 04/02/2026.

Civil penalties in the amount of $500 were issued.
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Based on interview, the licensee did not comply with the section cited above. Licensee's son-in-law (S5) who resides at the home and has not obtained clearance and is still 'in process' which poses an immediate health, safety or personal rights risk to persons in care. LPAs reminded licensee that all persons working, residing or volunteering shall obtain a California clearance or a criminal record exemption as required by the Department.
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Type A
04/02/2026
Section Cited
CCR102417(g)(4)

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(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
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Licensee to submit picture proof to LPA by plan of correction date of 04/02/2026
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Based on observations and interview, the licensee did not comply with the section cited above which poses a immediate health, safety or personal rights risk to persons in care. LPAs observed dishwashing tablets, hydrogen peroxide solution, vinegar in the dining area, medications on a low shelf in the hallway and master bedroom and cosmetic products in a low shelf in the master bathroom. All items are observed to be within reach of children in care. LPAs reminded Licensee that these items needs to be placed in high cabinets, off limit areas or in child locked cabinets to prevent access by children.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/01/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/01/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/01/2026 12:58 PM - It Cannot Be Edited


Created By: Farida Raja On 04/01/2026 at 11:26 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAAVEDRA, ARACELI
FACILITY NUMBER: 274407058

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/01/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/17/2026
Section Cited
CCR
102416.3(a)(6)

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(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:
(6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care. This requirement is not met as evidenced by:
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Licensee to submit a written plan of correction to LPA by plan of correction date on 04/17/2026.
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Based on observations and interview with Licensee she stated that since the on limit bathroom is under construction, children are using the off limit master bathroom until the on limit bathroom is fixed. LPAs reminded Licensee that the Department needs to be informed of any changes to on limit area prior to use of off limit areas for children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Farida Raja
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/01/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/01/2026


LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SAAVEDRA, ARACELI
FACILITY NUMBER: 274407058
VISIT DATE: 04/01/2026
NARRATIVE
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LPAs reminded Licensee that the Department needs to be informed of any changes to on limit areas prior to use of off limit areas for children in care. LPAs also observed dishwashing tablets, hydrogen peroxide solution, vinegar in the on limit dining area, medications on low shelves in the hallway and in the master bedroom and cosmetic products on a low shelf in the master bathroom within reach of children. LPAs reminded Licensee that all cleaning products, air fresheners, razors, mouthwash, perfumes and similar items need to be placed inaccessible to children. All items stating keep out of reach of children need to be placed in high cabinets, off limit areas or in child locked cabinets to prevent access by children.

Two Type A deficiencies and one Type B deficiency was cited today on the attached LIC 809D pages. LPAs informed licensee, Araceli Saavedra that this report dated 04/01/2026 documents one Type A citation. Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Raja informed the licensee to provide a copy of this licensing report dated 04/01/2026 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Civil penalties were issued. Appeal rights and LIC 9224 were printed and provided to Licensee.

Licensee provided an updated Application for a Family Child Care License (LIC 279) and Current Children in Home (LIC 279B) form during today's inspection. LPAs provided Licensee with an Entrance Checklist- Family Child Care Home (LIC 126) during today's inspection. Licensee to also submit proof of negative tuberculosis test for all adults stated as residing in the home to LPA by 04/17/2026.

Exit interview conducted and report was reviewed with and translated for Licensee, Araceli Saavedra.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2026
LIC809 (FAS) - (06/04)
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