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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274450252
Report Date: 02/06/2023
Date Signed: 02/06/2023 10:12:21 AM

Document Has Been Signed on 02/06/2023 10:12 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:ROCHA, BLANCA ESTELLAFACILITY NUMBER:
274450252
ADMINISTRATOR:ROCHA, BLANCA ESTELLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 761-2540
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 1DATE:
02/06/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:37 AM
MET WITH:Blanca Estella RochaTIME COMPLETED:
10:22 AM
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Licensing Program Analysts (LPAs), Cortney Nelson and Ashley Lopez, met with the Licensee, Blanca Estella Rocha, to follow-up on Plan of Correction (POC) issued during annual visit on 2/2/2023.

LPAs observed that Blanca's kitchen, living room, and backyard are cleaned and safe for day care children. The refrigerator is now cleaned of spoiled food and safe for food being served to children. The carpet in the living room appeared to be cleaned and visible staining is now gone. The backyard plastic items were removed and trash was emptied.

LPAs advised Blanca that her deficiencies have been cleared and gave her proof of clearance. LPA's additionally advised Blanca that she will still need to get LIC9224 signed by all new enrollment guardian/parents at her Family Child Care Home (FCCH) for the next 12 months (until 2/2/2024). LPA's confirmed that LIC9224 was signed for all children currently enrolled at the FCCH.

LPA's reviewed new hire paperwork for Blanca's incoming assistant, Leticia. LPA's advised Blance of enrolling into Guardian for review of fingerprint clearances and provided her with enrollment sheet.

Exit interview conducted and report was reviewed with the Licensee, Blanca Estella Rocha.

As a result of todays inspection, no deficiencies were cited.

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: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2023
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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