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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430702352
Report Date: 12/10/2024
Date Signed: 12/10/2024 12:23:34 PM

Document Has Been Signed on 12/10/2024 12:23 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:VALLEY PINESFACILITY NUMBER:
430702352
ADMINISTRATOR/
DIRECTOR:		HEINAN, JAMESFACILITY TYPE:
740
ADDRESS:545 EAST MAIN AVENUETELEPHONE:
(408) 779-2855
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY: 49TOTAL ENROLLED CHILDREN: 0CENSUS: 15DATE:
12/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:55 AM
MET WITH:James HeinanTIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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Licensing Program Analysts (LPAs) Christine Dolores and Marcella Tarin arrived unannounced to conduct a case management visit to deliver an immediate exclusion letter for staff (S1). LPA met with Administrator/Licensee James Heinan.

LPAs provided a letter "Order to Licensee/Facility of Immediate Exclusion From Facility" that the department determine that S1 engaged in conduct inimical as a staff in a facility. ADM was informed to remove S1 from any contact with residents and S1 may not be physically present in any facility.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Administrator/Licensee James Heinan and a copy of the report was provided.
Sarah YipTELEPHONE: (408) 324-2131
Christine DoloresTELEPHONE: (408) 334-8552
DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2024
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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