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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415606
Report Date: 04/20/2022
Date Signed: 04/20/2022 12:07:24 PM


Document Has Been Signed on 04/20/2022 12:07 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:KNOEFEL, TAMARAFACILITY NUMBER:
434415606
ADMINISTRATOR:TAMARA KNOEFELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 930-2078
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:14CENSUS: 12DATE:
04/20/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Tamara KnoefelTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Mel Matos conducted an unannounced case management inspection and met with Tamara Knoefel, Licensee. Purpose of today's inspection: Unusual Incident that the Licensee self reported to the Department. LPA also observed 12 day care children (3 infants & 9 preschool), Licensee's spouse (Andreas), and Licensee's adult daughter (Ariana) in the home during today's inspection.

Licensee self reported an Unusual Incident to the Department on April 1, 2022 in response to communication that she received from the parent of a day care child on March 31, 2022. Licensee states that the parent reported to her that another day care child had poked her child in the private area. Licensee states that no other specific details (when and where it occurred) provided to her. Licensee states that the day care children are supervised at all times by herself, her spouse, and one adult daughter, including when they go to the bathroom and nap time. Licensee states that she has not observed or heard of any inappropriate behavior by the day care children. Licensee states that she also spoke with both day care children and states that there was no credible evidence to substantiate the parent statement made to her on March 31, 2022.

Licensee states that the child's mother has not mentioned anything else to her since the March 31, 2022 contact. Licensee states that both children are still enrolled in the day care and she has concluded that there was no inappropriate behavior amongst any of the day care children.

No deficiencies issued. 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: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2022
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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