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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274407693
Report Date: 09/04/2024
Date Signed: 09/04/2024 02:22:13 PM

Document Has Been Signed on 09/04/2024 02:22 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ORTIZ, ESPERANZAFACILITY NUMBER:
274407693
ADMINISTRATOR/
DIRECTOR:		ORTIZ, ESPERANZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 763-2650
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
09/04/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:Esperanza OrtizTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 09/04/2024 at 1:25 PM, Licensing Program Analyst (LPA) Teodoro Trujillo met with licensee, Esperanza Oritz for a case management visit to amend report issued on 01/18/2024 and 04/30/2024. Present were licensee, her spouse, her daughters boyfriend , Keith and her assistant Mariana with 7 daycare children: One (1) infant, Six (6) preschool age.

Type A deficiency issued on 01/18/24 and Type B issues on 04/30/24 have been cleared due to licensee appeal.

No deficiencies were cited during today's visit. Exit interview was conducted and report was reviewed with Licensee, Esperanza Ortiz.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/04/2024
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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