<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435201951
Report Date: 12/10/2024
Date Signed: 12/10/2024 10:43:26 AM

Document Has Been Signed on 12/10/2024 10:43 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:PENDAR'S RESIDENTIAL CAREFACILITY NUMBER:
435201951
ADMINISTRATOR/
DIRECTOR:		MILA VALISTOFACILITY TYPE:
740
ADDRESS:515 TUSCARORA DR.TELEPHONE:
(408) 784-3669
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
12/10/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Staff - Mario LaganTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/10/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced collateral visit to deliver findings regarding a complaint from the licensees closed facility Pendar's Residential Care #435294025. LPA met with staff Mario Lagan and explained the purpose of today's visit.

LPA spoke to the licensee Marie Pendar to discuss findings over the phone. While at the facility LPA spoke to staff Mario Lagan to discuss the findings and inform that this is to deliver the findings regarding the closed facility. He confirmed with Marie LPAs presence and discussion and receipt of the complaint findings.

Report is reviewed with Mario and a copy is provided.
Cara SmithTELEPHONE: (650) 266-8889
Jaime VadoTELEPHONE: (559) 476-9353
DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1