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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412709
Report Date: 10/07/2022
Date Signed: 10/07/2022 03:46:35 PM

Document Has Been Signed on 10/07/2022 03:46 PM - 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:BRIGHT STARZFACILITY NUMBER:
434412709
ADMINISTRATOR:MARIA NAVARROFACILITY TYPE:
850
ADDRESS:810 WASHINGTON STREETTELEPHONE:
(408) 564-0863
CITY:SANTA CLARASTATE: CAZIP CODE:
95050
CAPACITY: 24TOTAL ENROLLED CHILDREN: 21CENSUS: 18DATE:
10/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Maria NavarroTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Mel Matos conducted an unannounced case management inspection and met with Maria Navarro, Licensee/Director.

LPA reminded Maria that she must have the most current version of the required
Department forms for staff. LPA provided Maria with the Records to be Maintained at the Facility (LIC 311A) handout to Maria and provided her with the department website: www.ccld.ca.gov where she can also obtain the current version of the required Department forms.

Maria provided LPA with an updated copy of her CPR/First Aid certifications during today's inspection. Maria has at least four other staff who also have current CPR/First Aid certifications.

Maria Navarro, Licensee/Director reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.


No deficiencies issued during today's inspection.


Notice of site visit issued and must remain posted for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2022
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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