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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500444
Report Date: 08/14/2024
Date Signed: 08/14/2024 12:07:14 PM

Document Has Been Signed on 08/14/2024 12:07 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LUNA, YESENIAFACILITY NUMBER:
394500444
ADMINISTRATOR/
DIRECTOR:		LUNA, YESENIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 981-5344
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 4DATE:
08/14/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:25 AM
MET WITH:Yesenia LunaTIME VISIT/
INSPECTION COMPLETED:
12:20 PM
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On August 14, 2024, Licensing Program Analysts (LPAs) Elvira Sierra and Stacey Williams met with Licensee, Yesenia Luna for a collateral visit. Present in the facility was Licensee and Licensee's assistant caring for five children. LPAs observed care and supervision of children. The reason for the visit is to interview Licensee and two children regarding unrelated complaint at another facility. LPAs interviewed the Licensee and were unable to interview children at this time.

Notice of site visit posted. This report and Appeal of Rights were reviewed and provided to Licensee, Yesenia Luna. No deficiencies are observed during today's collateral visit.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
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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