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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274417753
Report Date: 06/05/2024
Date Signed: 06/05/2024 04:44:28 PM

Document Has Been Signed on 06/05/2024 04:44 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:BRAVO NAVARRO, LUCIAFACILITY NUMBER:
274417753
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
06/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:50 PM
MET WITH:Lucia Bravo NavarroTIME VISIT/
INSPECTION COMPLETED:
04:50 PM
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Licensing Program Analyst (LPA) Fermin Campos-Jaramillo conducted an announced case management inspection to the home today. LPA met with licensee Lucia Bravo Navarro. Licensee was providing care to 4 children today. LPA inspected the home to ensure licensee is operating according with regulations. LPA observed that the licensee is doing all the paper work required, included the safe sleep regulations. Licensee stated she started to work on 3/15/24 Licensee has not conducted and documented a fire drill yet, she was advised to conduct and document one before September 15, 2024. Technical assistance was provided.

No deficiencies were cited today.

A notice of Site inspection was printed and licensee was instructed to post it for 30 consecutive days
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024
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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