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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415910
Report Date: 02/15/2024
Date Signed: 02/15/2024 03:41:19 PM

Document Has Been Signed on 02/15/2024 03:41 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:CERVANTES, MARGARITAFACILITY NUMBER:
434415910
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 2DATE:
02/15/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Margarita CervantesTIME COMPLETED:
03:50 PM
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Licensing Program Analysts (LPAs) Deanna Villagrana and Martha Jimenez-Villanueva met with licensee Margarita Cervantes for a unannounced case management visit that licensee initiated. Licensee is requesting an increase of capacity. A fire clearance was approved on 02/01/2024. Present was licensee and one day care children. Licensee's adult daughter Diana Cervantes arrived with a school age child.

LPAs toured the indoor and outdoor areas of the home during today’s inspection. LPAs observed that the home is clean and orderly, with heating and ventilation for safety and comfort of the children. LPAs observed two barricaded wall heaters in the home. All sharp objects, detergents, cleaning compounds, medications, poisons, and other similar items inside the home are stored inaccessible to children. LPAs observed a fully charged 3A40BC fire extinguisher, a working smoke and carbon monoxide detector. Licensee states there are no weapons/firearms in the home. There are no bodies of water. Backyard is fenced. Licensee was approved by the fire department to use the backyard. LPAs observed the backyard is safe for children and has a large play structure and other items for day care children. Both sides of the home are free of debris and will be used as emergency exits. Licensee understands exits must be cleared at all times.

Exit interview conducted and report was reviewed with the licensee Margarita Cervantes. Licensee was informed a large Family Home Day Care license is approved today.

No deficiency was cited.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE: DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/15/2024
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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