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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415723
Report Date: 09/15/2022
Date Signed: 09/15/2022 10:44:20 AM


Document Has Been Signed on 09/15/2022 10:44 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:REACH MONTESSORI PRESCHOOLFACILITY NUMBER:
434415723
ADMINISTRATOR:JIAN DENGFACILITY TYPE:
850
ADDRESS:2490 STORY ROADTELEPHONE:
(408) 272-8888
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:60CENSUS: 21DATE:
09/15/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jian DengTIME COMPLETED:
11:00 AM
NARRATIVE
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Licensing Program Analyst (LPA), Oscar Huang, conducted an unannounced Plan of Correction (POC) to the Facility today. LPA met with director Jian (Annie) Deng, and explained the nature of today's visit to her. The purpose of the inspection is to review POCs for deficiencies that were cited on 8/19/2022. Present during today's inspection were director, 3 other teachers, and 21 preschool children.

The facility was issued four "Type B" deficiencies on Friday, 8/19, 2022 for Personal Rights, Limitation of Capacity, and Responsibility for Providing Care and Supervision. The Plan of Correction was due on 8/31/2022.

LPA observed the notice of site visit which was issued 8/19/2022, and was posted on the facility entrance door.

Licensee submitted a plan of correction statement to CCL on 8/25/2022, prior to POC due date.

LPA concludes that the the facility has completed its required plan of corrections and the deficiencies are thus cleared as of today's visit.

No deficiency was cited. Exit interview conducted with Director, Jian (Annie) Deng.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Yangcheng HuangTELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2022
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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