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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414541
Report Date: 12/10/2019
Date Signed: 12/10/2019 03:49:56 PM

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:TULIP KIDS ACADEMYFACILITY NUMBER:
434414541
ADMINISTRATOR:CLAUDIA ALBORNOZFACILITY TYPE:
830
ADDRESS:1279 LAWRENCE STATIONTELEPHONE:
(669) 255-0540
CITY:SUNNYVALESTATE: CAZIP CODE:
94089
CAPACITY:28CENSUS: 19DATE:
12/10/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Claudia AlbornozTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) met with Claudia Albornoz, director, for an unannounced case management inspection. Claudia states that she will be on maternity leave as of April 1, 2020 & that the Facility is in process of finding/appointing a substitute director.

LPA advised Claudia of the requirement (per Title 22, Section 101215.1 - Child Care Center Directors Qualifications and Duties) to notify licensing when the Facility director is going to absent more than 30 consecutive days. The Facility will also need to submit the pertinent paperwork for the "substitute" director to the licensing.

LPA also discussed the requirement (per Title 22, Section 101415.1 - Assistant Infant Care Center Director Qualifications and Duties) to have an assistant director in place for the infant license at all times.

LPA reminded Claudia that there needs to be one fully qualified teacher present for every 12 infants in the infant room.

LPA provided Claudia with the checklist of the required paperwork for a director/assistant director prior to the conclusion of today's inspection.

No deficiencies issued during today's inspection.


A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, 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: 12/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019
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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