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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410442
Report Date: 01/31/2024
Date Signed: 01/31/2024 02:27:48 PM

Document Has Been Signed on 01/31/2024 02:27 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SUAZO, SOFIAFACILITY NUMBER:
434410442
ADMINISTRATOR:SUAZO, SOFIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 249-0353
CITY:SAN JOSESTATE: CAZIP CODE:
95128
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
01/31/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sofia SuazoTIME COMPLETED:
02:40 PM
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Licensing Program Analysts (LPA) Marilou Monico and Mandeep Kaur met with Licensee, Sofia Suazo, and conducted a Plan of Correction Inspection. Licensee was cited on January 22, 2024 under Staffing Ratio and Capacity, Infant Safe Sleep, and Health & Safety.

During today's inspection, LPAs observed the following:
1) Two adults (Licensee and her mother-in-law) supervising eight children including one infant and seven preschool age.
2) An infant sleeping in the playpen. There were no items in the playpen and no hanging objects.
3) Completed sleep log for infants in care.
4) Signed Acknowledgement of Receipt of Licensing Report (LIC 9224) in the children's files.

The deficiencies under ratio and safe sleep are hereby corrected and cleared.

There were no deficiencies cited.

Exit interview conducted and report was reviewed with Licensee, Sofia Suazo.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2024
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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