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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413759
Report Date: 03/16/2022
Date Signed: 03/16/2022 10:58:09 AM


Document Has Been Signed on 03/16/2022 10:58 AM - 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:ACCELERATION ACADEMYFACILITY NUMBER:
434413759
ADMINISTRATOR:JYOTI DAWRAFACILITY TYPE:
850
ADDRESS:743 S WOLFE ROADTELEPHONE:
(408) 732-2200
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:86CENSUS: 39DATE:
03/16/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Bhawna PatkarTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Mel Matos met with Bhawna Patkar, Licensee representative, for an unannounced case management inspection. Purpose of inspection: address overdue fees for one of Bhawna's other licensed facilities.

Bhawna has another facility located at 404 E Evelyn Ave, Sunnyvale, CA 94086 (Facility #: 434412146) which currently has overdue licensing fees. Licensing fees for the Evelyn location were due March 1, 2022.

Bhawna states that the Facility on E Evelyn Ave has been closed since March 2020 due to the pandemic and she is not sure if she will reopen the Facility. LPA advised Bhawna that licensing fees must be current; otherwise, the Department can close out the Facility license due to "non payment" of licensing fees.

Bhawna states that she understands LPA's explanation and will submit her annual fee payment shortly.

No deficiencies issued during today's inspection.

Notice of site visit was issued and must remain posted in a visible location for 30 days.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:
DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2022
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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