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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415215
Report Date: 01/17/2023
Date Signed: 01/17/2023 11:05:43 AM

Document Has Been Signed on 01/17/2023 11:05 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:LIDIA'S PRESCHOOL AND DAY CARE CENTERFACILITY NUMBER:
434415215
ADMINISTRATOR:ATKINS, MARIAFACILITY TYPE:
850
ADDRESS:637 CALERO AVENUETELEPHONE:
(669) 234-7886
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 0DATE:
01/17/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Maria Atkins & David AtkinsTIME COMPLETED:
11:15 AM
NARRATIVE
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Licensing Program Analyst (LPA) Janette Cruz and Regional Manager (RM) Anthony Studebaker conducted an announced Office Meeting to discuss the facilities recent non-compliance. LPA and RM reviewed the facilities recent deficiencies and items that need to be completed. If the facility continues to have non-compliance issues the facility license could be referred to the Department’s legal division for administrative action, up to and including revocation. The facility will receive increased monitoring over the next 12 months. Facility was provided a LIC 9111, Noncompliance Conference Summary, that details the information discussed. A copy of the LIC 9111 will be placed in the public section of the facility file that is maintained at the Department’s regional office and is available for public review.

No deficiencies were issued during today’s meeting.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023
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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