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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435390025
Report Date: 05/25/2022
Date Signed: 05/25/2022 10:01:25 AM

Document Has Been Signed on 05/25/2022 10:01 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. 350
SAN JOSE, CA 95131
FACILITY NAME:SENECA FAMILY OF AGENCIES-THE WELCOMING CENTERFACILITY NUMBER:
435390025
ADMINISTRATOR:JESSICA ESCHMANFACILITY TYPE:
722
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 15CENSUS: 3DATE:
05/25/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Jesse EischmanTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Monica Pavia met with Jesse Eischman, to close an incident from March 2022, where a client's biological mother reported the client reported to her, that a staff "put hands on her".

Interviews were conducted. There were no Title 22 deficiencies cited.

This case management inspection is now closed.
SUPERVISORS NAME: Carolyn Flynn
LICENSING EVALUATOR NAME: Monica Pavia
LICENSING EVALUATOR SIGNATURE: DATE: 05/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/25/2022
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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