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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409633
Report Date: 12/20/2022
Date Signed: 12/20/2022 10:19:02 AM

Document Has Been Signed on 12/20/2022 10:19 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:CASTRO, KIMFACILITY NUMBER:
434409633
ADMINISTRATOR:CASTRO, KIMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 600-8280
CITY:SAN JOSESTATE: CAZIP CODE:
95111
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
12/20/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Castro, KimTIME COMPLETED:
10:30 AM
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On this day Licensing Program Analyst (LPA), Almaraz, conducted an unannounced case management inspection follow up based on licensee report that there pests in the outer area of the day care. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPA met with licensee Castro, Kim and explained the nature of today's inspection. Present during the inspection was licensee and three children, including two infants and school age. Personal rights observed.

Per Licensee pest control was called and they conducted a visit on or around 11/01/2022. LPA inspected the facility, including the outer areas. LPA observed this facility to be free of pests. This facility is observed to be in compliance with Regulation 102423 (2) the right to "receive safe, healthful, and comfortable accommodations" and meets the standards of safe and healthful accommodations. No further follow up is needed at this point.

There are no deficiencies issued in accordance with Chapter 1, Division 12, Title 22 of the California Code of Regulations. An exit interview conducted, and report was reviewed with licensee.

NOTICE OF SITE VISIT ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.




SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2022
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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