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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313624356
Report Date: 01/10/2023
Date Signed: 01/10/2023 11:23:36 AM

Document Has Been Signed on 01/10/2023 11:23 AM - 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:ALDEA, MIRLAFACILITY NUMBER:
313624356
ADMINISTRATOR:ALDEA, MIRLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 293-1492
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
01/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Mirla AldeaTIME COMPLETED:
11:45 AM
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LPA Amanda Blesi met with Mirla Aldea and her husband Joseph for a case management visit on this date to discuss the unusual incident report (UIR) that the facility submitted and which occurred on 12/22/22. Present today were three day care children ages 3, and two infants. During today's visit the home was toured and interviews were conducted. The UIR was self reported by the licensee after a parent reported their child felt their personal rights were violated during a lunchtime encounter. LPA interviewed one child in care, however; due to the child's age, very little information could be obtained.

No deficiencies were cited today.
Exit interview with licensee and her husband Joseph.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2023
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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