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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415622
Report Date: 11/29/2021
Date Signed: 11/29/2021 11:21:38 AM

Document Has Been Signed on 11/29/2021 11:21 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:MENDOZA MENDEZ, MAYRAFACILITY NUMBER:
434415622
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
11/29/2021
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Mayra Mendoza MendezTIME COMPLETED:
11:30 AM
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Licensing Program Manager (LPM) Mary Segura, and Licensing Program Analyst (LPA) Fermin Campos-Jaramillo met with licensee Mayra Mendoza Mendez in an informal in office meeting to discuss the licensee's application for increase of capacity on her Family Child Care Home (FCCH) license, and to discuss the most recent deficiencies cited to her license on 11/05/21.
During the meeting licensee had the opportunity to explain the reasons why she was out of compliance with the regulations. LPM explained to licensee the seriousness of the deficiency on been out of ratio and capacity specially on providing childcare to young infants. Licensee stated she recognized during some weeks she was providing childcare to five infants, and stated she was unaware of the regulations on ratio and capacity for an small FCCH license.
Also LPM discussed with licensee the deficiencies related to hiring helpers, the need of keeping a children's roster current and complete, regulations related to children's files, regulations related to a healthy and safe environment for the children in care, and regulations related to safe sleep for infants.
Licensee was explained with her options on the increase of capacity application, after the discussion of the facts, licensee today November 29, 2021 decided on withdrawing her increased of capacity application, so she can demonstrate to the Licensing Department that she can substantially comply with all the regulations governing the FCCH.
Licensee was advised that closer supervision will be maintained on her license with more frequent unannounced inspections for the next 12 months.
Licensee understands that in the event that she does not understands the regulations she will reach to her LPA or the desk duty officer, and will ask clarification on any given issue.

This meeting was held in Spanish with licensee and LPA Campos-Jaramillo supported LPM with the translation.

No deficiencies have been cited today.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2021
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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