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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415399
Report Date: 03/12/2024
Date Signed: 03/12/2024 02:07:30 PM

Document Has Been Signed on 03/12/2024 02:07 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:MENDOZA, ALMA & CHAVEZ, MARIAFACILITY NUMBER:
434415399
ADMINISTRATOR:MENDOZA, ALMA & CHAVEZ, MAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 334-5018
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
03/12/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Alma MendozaTIME COMPLETED:
02:15 PM
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On 3/12/24 at 12:15pm, Licensing Program Analyst (LPA) Sheena Chin conducted an unannounced case management for change of facility sketch. LPA met with the licensee, Alma Mendoza and explained the purpose of the inspection. Present were the two licensees, and 6 children in care. The licensee stated that her sister and her two children, 10 and 12 years old, lived in the ADU.

On 2/21/24 The licensee notified the San Jose Reginal Office that the accessory dwelling unit (ADU) with 725 square feet in the backyard has been completed. LPA advised the licensee that per regulation 102416.3 Alterations to Existing Buildings or Grounds (b) The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction. LPA advised the licensee to send the inspection report from her local inspector.On 2/21/24 the licensee returned the email and attached the inspection report from City of San Jose. The Permit number is #2022-673831-RS on the location of 1400 Whitton Ave.

LPA along with the licensee toured the backyard. LPA observed that the ADU did not have independent access but there was a gate when entering the backyard. Trash bags and broken doors of the shed were observed. The licensee stated that children did not use the backyard due to rainy days. LPA advised the licensee to clear out the trash bags and fix the broken doors of the shed.

The licensee stated that she would have constructions soon. The licensee stated that her application for grants was approved by the Santa Clara County and she planned to add a playroom in the backyard and renovate the laundry room. LPA advised the licensee to put a fence in the front yard and supervise children when they play outside. The licensee stated that she understood it’s required to supervise children in care at all times.

No deficiencies were cited. Exit interview conducted and report was reviewed with Alma Mendoza. 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: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2024
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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