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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416782
Report Date: 09/01/2022
Date Signed: 09/01/2022 12:33:42 PM

Document Has Been Signed on 09/01/2022 12:33 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:PUENTES, LILIANAFACILITY NUMBER:
434416782
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
09/01/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:51 AM
MET WITH:Liliana PuentesTIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Marilou Monico met with Licensee, Liliana Puentes, for a case management inspection in response to a request to add the family room as part of the daycare. Also present in the home were licensee's husband and a daycare child.

During today's inspection, LPA toured the facility both indoor and outdoor and reviewed a child's file. Off limit areas inside the home are: laundry room, kitchen, garage and entire upper level (three bedrooms and two bathrooms). Off limit areas outdoor: fenced area of the backyard and right side yard.

LPA advised licensee that she can now use the family room for daycare purposes.

There were no deficiencies cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/01/2022
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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