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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415720
Report Date: 11/16/2023
Date Signed: 11/16/2023 03:40:00 PM


Document Has Been Signed on 11/16/2023 03:40 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:LAUREL PLAYGARDENSFACILITY NUMBER:
434415720
ADMINISTRATOR:KRISTINA SORENSEN MUSGRAVEFACILITY TYPE:
850
ADDRESS:1050 PARK AVENUETELEPHONE:
(408) 645-5783
CITY:SAN JOSESTATE: CAZIP CODE:
95126
CAPACITY:47CENSUS: 23DATE:
11/16/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Aakriti Beri & Rahul BeriTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA), Marilou Monico, conducted an unannounced Case Management Inspection. LPA met with Licensee Representative, Aakriti Beri, and CEO, Rahul Beri. The Licensee Representative requested to increase the capacity from 47 to 52 children in the preschool program. An initial Case Management Inspection was conducted on October 5, 2023. LPA observed that the faucet in the kitchen has hot and cold running water.

Licensee Representative requested to include an additional outdoor play area for the preschool children. The following outdoor measurements were taken during the inspection:
Preschool Play Yard (adjacent to Infant Play Yard) =(42.83 x 18.25) + (34.83 x 36.42) = 2,050.16 minus 187.50 (encumbered space) = 1,862.66 sq. ft.

The following outdoor measurements were taken by LPAs Pam Burkett and Tuoc Doan on January 24, 2018 (refer to Facility Evaluation Report dated 01/24/18):
BACK (53.0833 X 35.9167) + (15.9167 X 34.3333) + (13.0833 X 41.3333) = 2,993.81 sq.ft.
TOTAL OUTDOOR PRESCHOOL SPACE: 4,856.47 (1,862.66 + 2,993.81) sq.ft. divided by 75 sq. ft. = 64 children

The following must be completed prior to licensure of 52 children in the preschool program:
1) Preschool Play Yard must be fully set-up. Photos to be sent to Licensing.
2) Licensing Manager's review and approval.

There were no deficiencies cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2023
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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