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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417125
Report Date: 06/26/2024
Date Signed: 06/26/2024 02:12:22 PM

Document Has Been Signed on 06/26/2024 02:12 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:VARGAS CAMACHO, MARIAFACILITY NUMBER:
434417125
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
06/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Maria Vargas CamachoTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Mel Matos met with Maria Vargas Camacho, Licensee, for an unannounced case management inspection. No day care children were present in the home during today's inspection.

Licensee states that the day care is closed from June 24 to July 7, 2024 for summer break. Licensee states that the day care will reopen on Monday July 8, 2024.

Licensee inquired about applying for the large family child care home license. LPA advised Licensee that her "anniversary date" is August 9, 2024 and that she can submit her request to the Department 2-3 weeks prior. Licensee understands that she will need an approved fire clearance approval from the Sunnyvale Department of Public Safety and a follow up inspection from the Department prior to obtaining a large family child care home license.

Licensee understands that she needs to submit an Application for a Family Child Care Home License (LIC 279) along with a $25 payment payable to "DSS - Cashier" for the increase in capacity request.

Exit interview conducted and report was reviewed with the Licensee, Maria Vargas Camacho. No deficiencies issued during today's inspection.

Notice of site visit issued and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2024
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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