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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410805
Report Date: 03/24/2020
Date Signed: 03/24/2020 10:30:58 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:T'ENNA PRESCHOOL AT THE OSHMAN FAMILY JCCFACILITY NUMBER:
434410805
ADMINISTRATOR:MYKENZIE BUSSERFACILITY TYPE:
850
ADDRESS:3921 FABIAN WAYTELEPHONE:
(650) 223-8788
CITY:PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY:250CENSUS: 0DATE:
03/24/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:09 AM
MET WITH:Lauren BermanTIME COMPLETED:
10:50 AM
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Licensing Program Analysts (LPAs) Melanie Otsuji and Mayla Mendoza along with Licensing Program Manager (LPM) Wynn Norona met with Dave Rosenfeld, Director, Youth and Teens,
Afterschool Programs Director, Cyrus Mallare, Preschool Director, Lauren Berman.

The facility will temporarily serve Santa Clara County employee's children due to COVID-19 pandemic. Facility will operate Monday - Friday 6:30AM - 4:30PM.

Exit interview conducted. Notice of Site visit and appeal rights provided.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2020
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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