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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406156
Report Date: 06/09/2022
Date Signed: 06/09/2022 10:20:19 AM

Document Has Been Signed on 06/09/2022 10:20 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:SANDOVAL, VERONICAFACILITY NUMBER:
444406156
ADMINISTRATOR:VERONICA SANDOVALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 228-1035
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
06/09/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Veronica SandovalTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Licensee, Veronica Sandoval, and explained purpose of visit. Present at the facility upon arrival were 10 children (2 infants/ 1 preschool-age/ 7 school-age), Licensee, and Assistants, Paulina Ortiz & Bertha Solorzano, which is compliant with capacity and ratio requirements.

Todays visit is in response to failure to correct deficiencies cited on 5/25/2022. LPA received email correspondence from Licensee regarding deficiencies on 6/7/2022, however did not request an extension at that time. Extension requests must be made prior to the due date.

Previous Licensing Report (LIC809) dated 5/25/2022 gave notice that failure to correct would result in a civil penalty. Because correction was not made by 6/8/2022, three civil penalties of $100 per violation per day will be assessed until violation is corrected.

During today's inspection LPA additionally received updated children's roster to reflect all children currently enrolled at the family child care home.

Exit interview conducted with Licensee, Veronica Sandoval.

As a results of todays inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022
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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