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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414063
Report Date: 07/01/2022
Date Signed: 07/01/2022 09:11:54 AM

Document Has Been Signed on 07/01/2022 09:11 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ROJO, MAYRA GUADALUPEFACILITY NUMBER:
434414063
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 4DATE:
07/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Mayra Guadalupe RojoTIME COMPLETED:
09:20 AM
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On 07/01/2022 at 8:30am, Licensing Program Analyst (LPA) Christina Uribe met with licensee Mayra Rojo for the purpose of conducting an unannounced case management visit for a capacity increase. Present during today’s inspection is the licensee’s fingerprint cleared & associated assistant, Erika Gutierrez, and 4 daycare children. The home was toured for a health and safety inspection.

Application for Capacity Increase: All documents have been received for the increase of capacity application. The fire clearance for a capacity of 14 children was performed by the Mountain View Fire Department on 03/25/2022 and was granted approval. The licensee already has a hired and fingerprint cleared/associated adult assistant. The licensee was reminded that the assistant must be present at all times when there is more than 8 children in attendance. Whenever the assistant is not present, the licensee will comply with the capacity requirements for a small family child care home. Licensee has already submitted all of the required forms for her assistant to LPA Uribe.

The home is recommended for an increase of capacity. There are no deficiencies nor advisory notes cited during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Mayra Rojo.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2022
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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