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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
434413739
Report Date:
03/13/2025
Date Signed:
03/13/2025 08:43:35 AM
Document Has Been Signed on
03/13/2025 08:43 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
SAN JOSE CC RO
,
2580 N FIRST STREET, STE. 300
SAN JOSE
,
CA
95131
FACILITY NAME:
BAXTER, KRISTIN & JEFFREY
FACILITY NUMBER:
434413739
ADMINISTRATOR/
DIRECTOR:
KRISTIN & JEFFREY
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(408) 568-5484
CITY:
SAN JOSE
STATE:
CA
ZIP CODE:
95118
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
14
CENSUS:
2
DATE:
03/13/2025
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:
Kristin Baxter
TIME VISIT/
INSPECTION COMPLETED:
08:45 AM
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Licensing Program Analyst (LPA) Jennifer "Jen" Beehler conducted an unannounced case management visit. LPA was greeted by licensee and stated the purpose for the visit was to drop off the Notice of Site Visit from yesterday's inspection.
LPA provided the Notice.
SUPERVISORS NAME
:
Gladys Kuizon
LICENSING EVALUATOR NAME
:
Jennifer Beehler
LICENSING EVALUATOR SIGNATURE
:
DATE:
03/13/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/13/2025
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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