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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410968
Report Date: 11/09/2021
Date Signed: 11/09/2021 10:33:24 AM

Document Has Been Signed on 11/09/2021 10:33 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:CASTILLO, SILVIAFACILITY NUMBER:
444410968
ADMINISTRATOR:SILVIA CASTILLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 768-8352
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/09/2021
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Sylvia CastilloTIME COMPLETED:
10:35 AM
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On 11/09/2021 at 09:30 AM, Licensing Program Manager (LPM) Mary Segura and Licensing Program Analyst (LPA) Susy Cervantes, met with licensee, Sylvia Castillo, for an office visit in regards to an incident that occurred on Thursday 11/04/2021 in her family child care home.

Licensee was interviewed about the incidents that occurred. LPM informed licensee that depending on the outcome of the court, this incident could affect their license. Licensee will keep licensing updated about the case. Licensee will submit licensing report today 11/09/2021

Exit interview and report was reviewed with licensee, Sylvia Castillo. No deficiencies were cited during today's meeting.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2021
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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