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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274409364
Report Date: 11/15/2022
Date Signed: 11/15/2022 11:35:17 AM

Document Has Been Signed on 11/15/2022 11:35 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:PEREZ, GLORIAFACILITY NUMBER:
274409364
ADMINISTRATOR:GLORIA PEREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 754-2362
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/15/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Gloria PerezTIME COMPLETED:
10:50 AM
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Licensing Program Manager (LPM) Mary Segura, and Licensing Program Analyst (LPA) Fermin Campos-Jaramillo met with licensee Gloria Perez in an informal in office meeting. The purpose of the meeting is to discuss the licensee's Plan of Corrections (POC) for the most recent deficiency cited to her license on 11/04/22.
Licensee Perez was accompanied by her daughter and helper Gloria Rocha.
During the meeting, licensee Perez had the opportunity to explain the reasons why she was out of compliance with the regulations that govern her license. LPM explained to licensee the seriousness of the deficiency on failing to provide safe and healthy conditions in her Family Child Care Home (FCCH) to all the children in care.
Licensee has promised to inspect everyday the equipment, furniture, and the toys used in her daycare activities in order to verify they are in safe and working conditions. If any items are not in safe conditions, the licensee shall repair or replace immediately. Licensee resubmit today the statement for the POC, including what she would do after she reviews and found that maintenance is needed.
Licensee stated the bookcase and a wooded cart have been disposed and are not longer used in her FCCH.
Licensee was advised that closer supervision will be maintained on her license with more frequent unannounced inspections for the next 12 months.
LPA discussed the requirements of AB633 to licensee and provided her the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and licensee understands the requirements. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
This meeting was held in Spanish with the licensee Perez and her daughter Gloria Rocha. LPA Campos-Jaramillo supported The LPM Segura with the translation.

No deficiencies have been cited today.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2022
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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