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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413670
Report Date: 05/06/2024
Date Signed: 05/06/2024 01:02:32 PM

Document Has Been Signed on 05/06/2024 01:02 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:LARA-RAMIREZ, ROSIEFACILITY NUMBER:
434413670
ADMINISTRATOR/
DIRECTOR:		LARA, ROSIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 209-7040
CITY:SAN JOSESTATE: CAZIP CODE:
95127
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
05/06/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Rosie Lara-RamirezTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 5/6/24 Licensing Program Analyst (LPA) Sheena Chin conducted an unannounced Case Management – deficiencies inspection at the facility and met with the licensee, Rosie Lara-Ramirez. Present were the licensee, a helper, a behavioral therapist and 8 children in the facility.

On 4/5/24 LPA Chin conducted an unannounced annual inspection at the facility and deficiencies were cited. The licensee sent LPA copies of correction proofs in April 2024 but the deficiency, the background clearance for the licensee’s daughter was not received. LPA checked the Guardian, which did not show the name of the licensee’s daughter associated with the facility.

During today’s inspection the licensee provided a letter from Department of Justice. LPA did further research on Guardian and learned that the background check for the licensee’s daughter was still undergoing. Acknowledgement of receipt of licensing reports were observed signed by parents.

No regulatory violations were observed during today’s inspection.

Exit interview was conducted and report was reviewed with the licensee, Rosie Lara-Ramirez. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2024
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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