Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710447
Report Date: 04/05/2018
Date Signed 04/05/2018 11:55:20 AM

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:CARING HEARTS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
430710447
ADMINISTRATOR:DELORIS J. ARORAFACILITY TYPE:
830
ADDRESS:645 WEST FREMONT AVENUETELEPHONE:
(408) 245-6356
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:12CENSUS: 9DATE:
04/05/2018
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Deloris AroraTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA), Marilou Monico, met with Site Director, Deloris Arora, for a case management inspection to deliver an amended Facility Evaluation Report dated January 24, 2018.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2018
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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