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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274415989
Report Date: 11/16/2022
Date Signed: 11/16/2022 10:27:11 AM

Document Has Been Signed on 11/16/2022 10:27 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:RAMIREZ PEREZ, CARLOSFACILITY NUMBER:
274415989
ADMINISTRATOR:CARLOS RAMIREZ PEREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 214-4846
CITY:SALINASSTATE: CAZIP CODE:
93907
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/16/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Carlos Ramirez PerezTIME COMPLETED:
10:35 AM
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On 11/16/2022 at 10:00 AM Licensing Program Manager (LPM), Mary Segura, and Licensing Program Analyst (LPA), Susy Cervantes, met with licensee Carlos Ramirez Perez for an informal in office meeting. The purpose of the meeting is to discuss the licensee's Plan of Correction (POC) for a Type A deficiency that was cited on 10/03/22.

During the meeting, licensee had the opportunity to explain the reasons why they were out of compliance with the regulations that govern their license. LPM explained to licensee the seriousness of the deficiency on transporting children to other facilities without authorized consent. Licensee stated they will not be transporting children to other locations without parent/guardian written consent. LPA will increase visits in the next 12 months to ensure compliance with all regulatory requirements.

LPA discussed the requirements of AB633 to licensee and provided them 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.

No deficiencies were cited during today's meeting. Exit interview conducted and report was reviewed with licensee, Carlos Ramirez Perez.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2022
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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