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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444417084
Report Date: 08/02/2023
Date Signed: 08/02/2023 10:59:39 AM

Document Has Been Signed on 08/02/2023 10:59 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:JAIME ALLEN / HIDDEN TREASURESFACILITY NUMBER:
444417084
ADMINISTRATOR:JAIME ALLENFACILITY TYPE:
850
ADDRESS:4401 SCOTTS VALLEY DRIVETELEPHONE:
(831) 430-8725
CITY:SCOTTS VALLEYSTATE: CAZIP CODE:
95066
CAPACITY: 15TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/02/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jaime AllenTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Applicant, Jaime Allen, to review application corrections for child care center application submitted to the San Jose Regional Office.

During todays office visit, LPA Nelson reviewed Notification of Incomplete Application (LIC184) with Jaime and covered the following topics:

-Confirm whether the Applicant is an individual or LLC
-Discuss personnel requirements and minimum requirements for qualified staff
-Reviewed balance sheet, liabilities section
-Capacity and ratio requirements
-Monthly Operating Statement- program revenues, general administration, and physical plant
-Admission Agreement- termination of services, payment provisions
-Job Descriptions- educational requirements, work experience, required documents
-Personnel Policies
-Personnel on-the-job training topics (Section 101216)

LPA Nelson advised Jaime that she will email a copy of the CA Code of Regulations for Child Care Centers and Application Booklet for Child Care Centers(LIC281A).

LPA Nelson provided Jaime with LIC311A, evaluation of teacher/site director qualifications, and copies from application documents submitted.

LPA advised Jaime to submit revisions for her application by 8/31/2023, including documentation for LLC (if she decides to apply as LLC instead of individual) and revisions indicated on copied documents provided.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2023
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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