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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274417893
Report Date: 01/10/2025
Date Signed: 01/10/2025 02:46:06 PM

Document Has Been Signed on 01/10/2025 02:46 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CASTILLO-HARO, ELIZABETHFACILITY NUMBER:
274417893
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/10/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Elizabeth Castillo-HaroTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Martha Jimenez-Villanueva met with licensee Elizabeth Castillo-Haro for a case management visit in response to a request submitted by the licensee to add the backyard of the house off limits to on limits. Licensee explained in the Pre-licensing appointment on September 17, 2024 the backyard was not included because the backyard needs some reparations. Licensee stayed placed artificial grass in the areas needed and level out, uneven dirt in the garden area is also flat now and request the backyard as an area of care.

LPA was greeted by her aunt and a few minutes later licensee Elizabeth Castillo-Haro granted access to the house. Present at home were licensee, aunt and her two own children, no children in care. Licensee stayed that she will wait until the Department approved to use the backyard.

LPA observed and reviewed the LIC 999A and toured the backyard with licensee. LPA observed the backyard is fenced and the plant area is properly fenced with a wall cement and properly artificial grass area is in placed. No bodies of water were observed.

As a result of this visit, the backyard is approved to be used for the play area and outdoor activities for children in care effective today January 10, 2025.

Exit interview was conducted and this report was reviewed with Elizabeth Castillo-Haro.

NOTICE OF SITE VISIT WAS POSTED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2025
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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