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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625041
Report Date: 04/29/2024
Date Signed: 04/29/2024 11:50:37 AM

Document Has Been Signed on 04/29/2024 11:50 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CORTEZ, LEYLANE & CRUZ, GUSTAVOFACILITY NUMBER:
343625041
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
04/29/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Leylane Cortez and Gustavo CruzTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 4/29/2024, at approximately 11:20 AM, Licensing Program Analyst (LPA), Michelle Perez, met with licensees, Leylane Cortez and Gustavo Cruz, for the purpose of a change of capacity visit. Upon arrival were 6 children.

Licensee has requested to increase from a small family child care, to a large family child care. Licensee, Leylane, gave LPA a tour and explained what changes were made per the request of the fire department.
LPA observed all required changes and provided licensee with the large family ratio sheet as well as the assistant requirements, should the licensee need to hire additional help, in addition to her co-licensee (spouse).

Effective today, 04/29/2024, the facility is approved for a large capacity to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of two years.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2024
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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