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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412147
Report Date: 03/01/2023
Date Signed: 03/01/2023 02:30:16 PM


Document Has Been Signed on 03/01/2023 02:30 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:GROWING TREE LEARNING CENTER INC.FACILITY NUMBER:
434412147
ADMINISTRATOR:CHEN, CHAOCHUANFACILITY TYPE:
850
ADDRESS:12220 SARATOGA-SUNNYVALE ROADTELEPHONE:
(408) 446-0243
CITY:SARATOGASTATE: CAZIP CODE:
95070
CAPACITY:102CENSUS: 49DATE:
03/01/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Cindy HuangTIME COMPLETED:
02:40 PM
NARRATIVE
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Licensing Program Analyst (LPA) Oscar Huang conducted an unannounced Case Management - Lead Testing/Exceedance inspection to the facility. LPA met with Regional Director Cindy Huang & Assistant Director Ting Wang and explained the reason for this inspection. The purpose of this inspection is that the facility had a result of 6 ppb which is over 5ppb on their kitchen water faucet of their initial test on 12/14/2022.

During today's inspection, LPAs inspected the water faucet/sink in the kitchen and observed that the filter system under the sink has been replaced. Director Huang stated that a retest was conducted on 02/06/2023 and was passed with a 'ND' (No Detected) result. The facility received the official report on 02/47/2023, and LPA obtained the report on site.

Exit interview conducted and report was reviewed with Regional Director Cindy Huang . A notice site visit has been issued and must remain posted for 30 days.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Yangcheng HuangTELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2023
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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