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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430700665
Report Date: 07/25/2019
Date Signed: 07/25/2019 09:51:59 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:VILLAGE PRESCHOOLFACILITY NUMBER:
430700665
ADMINISTRATOR:LINDA KERIN GARVEYFACILITY TYPE:
850
ADDRESS:20390 PARK PLACETELEPHONE:
(408) 867-3181
CITY:SARATOGASTATE: CAZIP CODE:
95070
CAPACITY:65CENSUS: 10DATE:
07/25/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:28 AM
MET WITH:Linda Kerin GarveyTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Stephanie Rangel conducted a case management- licensee initiated inspection and met with Site Director Linda Kerin Garvey. LPA arrived today in response to Facility's request to add the the following rooms that are located on the 2nd floor of the building: Chapel (216), Music (207), Fellowship (Douglass Hall) (208) and High School (210). These rooms will be used for occasional/seasonal use with examples as graduation, performances, and prayer service. The facility is also currently licensed in renamed rooms 101, 102, 103, 105, and 108 (previously licensed as rooms 1, 2, 3, 5, and 8). The Facility is currently not asking for an increase of capacity but, to be able to use the additional rooms and for the rooms to to be added to their license.

LPA toured the indoor and outdoor areas of the facility today. Fire clearance from the Santa Clara Co. Fire Department was granted on 6/5/19. Facility has been granted use of the additional space. Updated Facility sketch is filed and an updated license will be issued to the Facility.

As a result of this inspection, there are no deficiencies cited.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C RangelTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2019
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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