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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709377
Report Date: 02/13/2020
Date Signed: 02/13/2020 05:02:28 PM

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:PRIMARY PLUSFACILITY NUMBER:
430709377
ADMINISTRATOR:CHAPA, MELISSAFACILITY TYPE:
850
ADDRESS:18720 BUCKNALL ROADTELEPHONE:
(408) 370-0357
CITY:SARATOGASTATE: CAZIP CODE:
95070
CAPACITY:278CENSUS: 149DATE:
02/13/2020
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Melissa ChapaTIME COMPLETED:
05:15 PM
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An unannounced visit was made by Analyst Behbood to conduct required one year visit. Met Melissa Chapa and Shuree Guzman Director and Assistant Director respectively. Purpose of visit explained.
LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus (includes current and following week), and Activity Schedule.

During today's visit LPA inspected 13 classrooms, bathrooms and play area (3 playgrounds).
LPA observed that all children were properly signed in and out electronically in the office and each classroom keeps a class list.
Facility provides AM and PM snacks. Menus were posted. There is a small refrigerator abd microwave in each classroom. Children bring lunch from home. Some parents also send snack with children to center as well. Furniture & equipment appear in good condition. Floors appear clean. Children's bathrooms are in operating condition.
Playground has climbing structure, sand boxes, etc. Tan barks are used for cushioning material.
Drinking water inside the classrooms and in the playground are provided via water pitchers.

This one year required visit will continue in near feature due to shortage of time.
No citation issued during today's visit.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
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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