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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434407974
Report Date: 04/21/2022
Date Signed: 04/21/2022 03:57:44 PM


Document Has Been Signed on 04/21/2022 03:57 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:CANYON HEIGHTS ACADEMYFACILITY NUMBER:
434407974
ADMINISTRATOR:MARIJA PALIHNIC FISHERFACILITY TYPE:
850
ADDRESS:775 WALDO ROADTELEPHONE:
(408) 370-6727
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY:102CENSUS: 0DATE:
04/21/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Estela Zeik, PrincipalTIME COMPLETED:
04:10 PM
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Licensing Program Analyst (LPA), James Santos conducted an unannounced case management visit today and met with Estela Zeik, School Principal. The pre-school is currently closed since 4/15/2022 for spring break and will resume on 4/25/2022.

The purpose of the visit was in regards to their exception request for one of their day care children that is currently in their toddler program who turned turned 3 years old to be able to stay in their toddler program for two more months instead of being transferred to their preschool program.

Site Director, Marija Fisher was not present in the school during today's visit but LPA was able to speak to her on the phone. Per Director, she spoke with the child's parents and have agreed for the child to try and attend pre-school. Director stated that the child is currently doing well in their pre-school program so the exception is not needed for now.

Director will contact LPA if a follow up will be needed.

Exit interview conducted a copy of this report was provided to Mrs. Zeik.


NOTICE OF SITE VISIT ISSUED, POSTED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:
DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/21/2022
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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