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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400063
Report Date: 05/11/2023
Date Signed: 05/11/2023 12:51:57 PM

Document Has Been Signed on 05/11/2023 12:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:YMCA @ SILVER OAK ELEMENTARYFACILITY NUMBER:
434400063
ADMINISTRATOR:ANTHONY ARZADONFACILITY TYPE:
840
ADDRESS:5000 FARNSWORTH DRIVETELEPHONE:
(408) 223-4524
CITY:SAN JOSESTATE: CAZIP CODE:
95138
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 0DATE:
05/11/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Laura ZaragozaTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Pete Hernandez conducted an unannounced Case Management - other inspection in lieu of a required 1 year inspection because the Director states that they are under the school district program now and not under CCLD.. LPA met with Site Supervisor Laudra Zaragoza and explained the reason for the inspection. Program Director Angela Rodriquez was placed on the phone shortly after. Facility is located in the YMCA portable and G4 on the Silver Oak Elementary School campus.

Angela Rodriguez explained that they are no longer under CCLD and that our department should have received a letter explaining that this facility will now be under an arrangement with the school district. She also said that she would e-mail this letter to the LPA if she were provided a card. LPA noticed that there were no postings, and cleaners unlocked under the sink, and Director was not fingerprinted in LIS. .
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2023
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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