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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404385
Report Date: 06/16/2021
Date Signed: 06/17/2021 12:30:12 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:SJB - NORTHWOOD CHILD DEVELOPMENT CENTERFACILITY NUMBER:
434404385
ADMINISTRATOR:SABRINA FENECHFACILITY TYPE:
850
ADDRESS:2760 TRIMBLE ROADTELEPHONE:
(408) 719-1319
CITY:SAN JOSESTATE: CAZIP CODE:
95132
CAPACITY:48CENSUS: 0DATE:
06/16/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:MARIEL QUE & SABRINA FENECH TIME COMPLETED:
02:30 PM
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Licensing Program Analysts (LPA Stephanie Collins conducted an unannounced site inspection of the facility. LPA met with Site Director Sabrina Fenech and Regional Director Mariel Que and informed them the purpose of the visit.

Facility is requesting a Toddler Component be added to the Preschool license. Portable #700 will be dedicated to the Toddler Component. Inside Portable #700 there is a separate restroom for Toddlers to utilize with one toilet and one sink. Isolated sick children will use the director’s office and emergency equipment is available.

First aid supplies are stored in a cabinet that is inaccessible to children. Cleaning supplies are stored appropriately and are inaccessible. Portable 2 has a sink with hot and cold water, a microwave, and a refrigerator. All food is prepped off-site and brought to the individual portables on a daily basis. Disposable dishes and utensils are provided. The Toddlerl has enough cubbies, tables, chairs, and cots. There are adequate furniture, equipment, supplies and toys for children. Drinking water is available thru water dispenser.

LPA inspected Portable #700. Smoke and Carbon Monoxide Detectors were observed. Fully charge fire extinguisher was observed . LPA observed facility has a San Jose Fire Safety and Hazardous Materials Permit that expires on 09/302021. LPA observed sufficient tables, chairs, and cots the capacity requested.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SJB - NORTHWOOD CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434404385
VISIT DATE: 06/16/2021
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Portable #700 was measured to ensure that there is at least 35 square feet of indoor activity space per child.

Portable #700 Indoor Activity Space Measurement
(measurements taken 2019)
= (Area) – (Encumbered Space)
= (994.694 sq. ft) – (31.836 sq. ft.)
= 962.858 sq. ft.

Total Indoor Activity Space- Toddler Program = (962.858 sq. ft.) divided by 35 sq. ft

= 27 Children

Toddler Play yard
(Total sq. ft). – (Encumbered space)
(6,030.45 sq. ft). – (80.28 sq. ft).
=5,950.17 sq. ft.

Total outdoor Activity Space = (5,950.17 sq. ft.) divided by ( 75 sq. ft./ child)
= 79 Children

(Indoor measurements taken/05/2009)
Portable # 600:= 1,563.27 sq. ft


This report was reviewed with Director The Increase in Capacity/Toddler component is approved per Management's final review and approve.
Pending documents.
1: Fire Clearance
1: Application 200A

No deficiencies, Notice of Site Visit given, must be kept poster for 30 days


SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
LIC809 (FAS) - (06/04)
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