<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434407664
Report Date: 04/07/2023
Date Signed: 04/11/2023 09:58:45 AM

Document Has Been Signed on 04/11/2023 09:58 AM - 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:GALSIM, MARIBELFACILITY NUMBER:
434407664
ADMINISTRATOR:GALSIM, MARIBELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 528-7340
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
04/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Maribel GalsimTIME COMPLETED:
09:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Farida Raja, conducted a case management visit to obtain Licensee, Maribel Galsim's, signature on the civil penalty assessment form (LIC 421BG) for an inspection conducted on 04/06/2023. LPA observed 4 adults (Licensee, Licensee's- Mother and two sisters and 7 children (2 infants and 5 preschool) during today's visit.

Children were engaged in free play under staff supervision.

No deficiencies were cited as a result of today's inspection. Exit interview was conducted with Licensee, Maribel Galsim.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2023
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 1