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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404062
Report Date: 01/20/2023
Date Signed: 01/20/2023 02:53:50 PM

Document Has Been Signed on 01/20/2023 02:53 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:HERNANDEZ, MARIAFACILITY NUMBER:
434404062
ADMINISTRATOR:HERNANDEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 272-7290
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
01/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Maria HernandezTIME COMPLETED:
02:20 PM
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Licensing Program Analyst(LPA) Anna Morales came to conduct an ANNUAL REQUIRED inspection and was greeted by Licensee Maria Hernandez. Upon arrival, Licensee informed LPA that today was her last day operating her family child day care.

Licensee informed LPA that all of the parents were notified and their children have found placement.

Licensee gave LPA Morales her Day Care Licensee and a written statement stating that effective today, January 20, 2023, was her last day operating as a Family Child Day Care.

LPA observed four children ( one infant over twelve months, and three pre-school aged children) taking their naps.

No deficiencies cited at today's visit.

Exit interview was conducted with Licensee.






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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/20/2023
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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