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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412730
Report Date: 08/02/2023
Date Signed: 08/02/2023 02:33:39 PM


Document Has Been Signed on 08/02/2023 02:33 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:LEGACY CHRISTIAN PRESCHOOLFACILITY NUMBER:
434412730
ADMINISTRATOR:LUCY NUNEZFACILITY TYPE:
850
ADDRESS:420 ALLEGAN CIRCLETELEPHONE:
(408) 225-5976
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:100CENSUS: 40DATE:
08/02/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:34 PM
MET WITH:Shannon HernandezTIME COMPLETED:
03:00 PM
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Licensing Program Analysts (LPAs) Janette Cruz and Harsimran Kaur met with Shannon Hernandez, interim Director, for an unannounced case management inspection in response to facility’s request to approve classroom reconfiguration of Room A that used to be Rooms A and B. LPAs note that a wall was torn down from Room A and B to convert it to a single classroom (Room A). Present during the inspection were 41 children and six staff. LPAs were taken on a guided tour of the licensed classrooms and observed the following: Rooms 112, 113 Cafeteria, 1 & 2 are currently in use. LPA observed Room A is not yet being used but is slated to be utilized by start of school year upon department’s approval. LPAs inspected the licensed classrooms. LPAs observed that items that may pose danger to children were stored inaccessible to children. There were furniture, such as tables and chairs available for children.

The capacity remains unchanged at 100 preschool children. Hours of operation: 7:00AM – 6:00PM, Monday to Friday during the months of mid August until mid May and 8:00 to 5:00PM, Monday to Friday during the months of June thru beginning of August. The San Jose Regional office received an APPROVED fire clearance from the San Jose Fire Department on 07/28/2023

INDOOR MEASUREMENT:
LPA notes that previous measurements taken on 07/26/2017 show that rooms #1, #2, 112 and 113 (Cafeteria) have adequate space for 70 children.

Room A (46.417 x 31.833) less encumbered space (5.833 x 2.500) + (22.667 x 5.083)
(1477.592) - (14.583 + 115.216) = 1347.793 sq. feet

Room A has enough space for 38 children.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette CruzTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LEGACY CHRISTIAN PRESCHOOL
FACILITY NUMBER: 434412730
VISIT DATE: 08/02/2023
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Exit interview conducted and report was reviewed with Shannon Hernandez, Interim Director, and advised her that Room A is to be approved for use as of 08/02/2023.

No deficiencies were cited during this visit.

Notice of site was visit given and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette CruzTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023
LIC809 (FAS) - (06/04)
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