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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408766
Report Date: 09/15/2021
Date Signed: 09/15/2021 03:10:03 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:STARBRIGHT SCHOOL - CAMPBELL CAMPUSFACILITY NUMBER:
434408766
ADMINISTRATOR:VARTAZAROVA, MARIANNAFACILITY TYPE:
850
ADDRESS:1806 WEST CAMPBELL AVENUETELEPHONE:
(408) 374-4020
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY:192CENSUS: 90DATE:
09/15/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Anastassia Ku, Operations ManagerTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA), James Santos conducted an unannounced case management visit today and met with Operations Manager, Anastassia Ku.

The licensee has requested to remove specific square footage from the total indoor space which was 9,050.323 sq ft.

Licensee requested to remove Room #12 which was measured at 658.135 sq ft and Room #13 which was measured at 677.905 sq ft which results in a reduction of total 1,336.04 sq ft. After removal, the total indoor space is now 7,714.283 sq ft. The total capacity of the License will stay the same which is 192 children.

LPA toured the facility with Operation Manager and inspected the two rooms. Based on indoor measurements, the facility is granted the request and will stay in the same capacity (192 children).

No deficiencies cited.


NOTICE OF SITE VISIT ISSUED, POSTED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
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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