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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410976
Report Date: 06/09/2022
Date Signed: 06/09/2022 10:56:39 AM

Document Has Been Signed on 06/09/2022 10:56 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:GARCIA, KARINAFACILITY NUMBER:
444410976
ADMINISTRATOR:KARINA GARCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 761-0338
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
06/09/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Karina GarciaTIME COMPLETED:
11:05 AM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Licensee, Karina Garcia, to follow-up on construction that has been completed at the Family Child Care Home (FCCH). Upon arrival, there were 14 children present (3 infants, 2 school-age, 9 preschool-age), Licensee, and Assistant, Maria Rodriguez Rocha, which is compliant with facility capacity and ratio requirements.

Construction at the FCCH was to add single family addition to the off-limits area of the home. (Construction Permit Parcel # 017-331-03) LPA inspected inside and outside of the facility during today's inspection and verified that all construction is completed and facility is safe for day care children. Fire inspection was completed by Watsonville Fire Department on 5/9/2022 and granted with no conditions.

Exit interview conducted with Licensee, Karina Garcia.

As a result of todays inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST BE POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022
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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