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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414171
Report Date: 01/10/2024
Date Signed: 01/10/2024 02:55:53 PM


Document Has Been Signed on 01/10/2024 02:55 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:LITTLE TREE MONTESSORI INTL.SCHOOL OF SUNNYVALEFACILITY NUMBER:
434414171
ADMINISTRATOR:YINGCHIA "EVA" LIUFACILITY TYPE:
850
ADDRESS:420 S. PASTORIA AVETELEPHONE:
(408) 462-9891
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:188CENSUS: 68DATE:
01/10/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Jacqueline "Jackie" FunkTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Mel Matos met with Jacqueline "Jackie" Funk, director, for an unannounced case management inspection. Purpose of today's inspection: discuss addition of toddler component to the existing preschool license.

Facility wishes to convert Room 2 for toddler children, ages 18 months to 30 months. LPA discussed the documents required to be submitted to add the toddler component to the existing preschool license.

LPA advised Jackie that a fire inspection will be requested once all documents have been submitted to the San Jose Child Care District Office. LPA Matos will conduct a follow up inspection once an approved fire clearance has been received by the Department.

Exit interview conducted and report was reviewed with the Director, Jackie Funk. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2024
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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