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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406156
Report Date: 05/21/2024
Date Signed: 05/21/2024 09:30:25 AM

Document Has Been Signed on 05/21/2024 09:30 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/
DIRECTOR:		VERONICA SANDOVALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 587-9289
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 3DATE:
05/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Veronica SandovalTIME VISIT/
INSPECTION COMPLETED:
09:40 AM
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Licensing Program Analysts (LPAs), Cortney Nelson and Jennifer 'Jen' Beehler, met with Licensee, Veronica Sandoval, and explained purpose of visit- to conduct quarterly visit in response to probationary license requirements. Upon arrival, LPAs were admitted into the home by the Licensee's adult daughter (S1) and LPAs observed the Licensee's Assistant (S5) was present with three (3) preschool-age children in care. S1 advised that the Licensee was at the grocery store and she returned approximately 10 minutes after arrival.

During tour of the home, LPA confirmed that all adults present have fingerprint clearances. Present in the home today were two of Veronica's adult children (S1 & S2) and her mother (S3). All conditions of the probationary license have been met during today's visit and LPA advised that continued quarterly visits will continue until 6/14/2025.

LPA again advised that no criminal record clearance has been obtained for S4 and the individual may not be present in the home.

As a result of today's inspection, no deficiencies were cited.

Exit interview conducted and report was reviewed with the Licensee, Veronica Sandoval.

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: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
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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