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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412224
Report Date: 07/16/2024
Date Signed: 07/16/2024 12:31:10 PM

Document Has Been Signed on 07/16/2024 12:31 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:DELGADO, MARIA DEL CARMENFACILITY NUMBER:
434412224
ADMINISTRATOR/
DIRECTOR:		DELGADO, MARIA DEL CARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 603-8341
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
07/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:35 AM
MET WITH:Maria Del Carmen DelgadoTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Deanna Villagrana met with licensee Maria Del Carmen Delgado for an Annual/Random visit. LPA explained the nature of the visit. Present were licensee only.

Licensee states she is on vacation and will be closed until July 29, 2024. LPA did not observe any children in care. LPA explained she would return to do a visit when children return.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2024
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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