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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440710119
Report Date: 08/14/2020
Date Signed: 08/18/2020 01:30:51 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:SIMCHA PRESCHOOLFACILITY NUMBER:
440710119
ADMINISTRATOR:LISA MENDEZFACILITY TYPE:
850
ADDRESS:3055 PORTER GULCH RDTELEPHONE:
8314793449
CITY:APTOSSTATE: CAZIP CODE:
95003
CAPACITY:35CENSUS: 0DATE:
08/14/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
11:06 AM
MET WITH:Melissa MendezTIME COMPLETED:
11:29 PM
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Licensing Program Analyst (LPA) Stephanie Collins conducted a scheduled Tele-Pre-Licensing inspection via video conference call with Center Director Lisa Mendez . Due to the COVID-19 situation and "Shelter in Place" Order, this LIC809 Facility Evaluation Report will be generated at the Licensing Office and emailed to the facility. Facility’s reply to the email will serve as acknowledgement that the report was received.

Licensee is applying for a capacity Increase; Currently licensed to use rooms 7,8, and 9 severing 35 preschoolers. Licensee submitted an application to add classroom six (6) and increase the current capacity from Thirty-five (35) to serving forty-five (45) pre-school children at; 3055 Porter Gulch Road, CA 95003. A Fire Clearance has been granted on 08/14/2020. The program will operate Monday through Friday from 07:30 AM to 05:20PM, serving children from 2yrs to entry into first grade. Facility's phone # (831) 479-3449.

Rooms 7, 8 and 9 were inspected and measured to determine the maximum capacity that meets the requirement of 35 square feet of indoor activity space and 75 square feet of outdoor activity space per child on 01/03/2008.
Pre-School Indoor Activity Space:
The indoor measurements are as follows:
PRESCHOOL ROOM 7 MEASURES: 442.062 DIVIDED BY 35 = 12 CHILDREN
PRESCHOOL ROOM 8 MEASURES: 569.526 DIVIDED BY 35 = 16 CHILDREN
PRESCHOOL ROOM 9 MEASURES: 270.430 DIVIDED BY 35 = 7 CHILDREN
INDOOR SPACE = 1282.018 sq. ft
LPA'S observed 3 toilets (45) and 6 sinks (90). Each classroom has its own toilet and 2 sinks. The facility has ample tables, chairs and cubbies. Drinking water is available both inside and outdoors.
Measurement was taken 01/03/2008.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2020
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SIMCHA PRESCHOOL
FACILITY NUMBER: 440710119
VISIT DATE: 08/14/2020
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Measurement was taken during LPA S. Collins Tele -Pre-Licensing inspection of classroom 6, on 08/14/2020.
Room 6 = (Total sq. ft. of Room 6) – (Total Encumbered Space in Room 6)
540.10 sq. ft sq. ft.) – ( 26.55 sq. ft.)
= 513.56 sq. ft.
513.56 sq. ft. + 1,282.018 sq. ft. =1,795.578 sq. ft.
TOTAL INDOOR SPACE -1,795.578. sq. ft. DIVIDED BY 35= 51. Children

OUTDOOR INFORMATION:
OUTDOOR SPACE USED BY ROOM 7 MEASURES: 1300.398 DIVIDED BY 75 = 17 CHILDREN
OUTDOOR SPACE USED BY ROOM 8 MEASURES: 9156.235 DIVIDED BY 75 = 122 CHILDREN
OUTDOOR SPACE USED BY ROOM 9 MEASURES: 798 DIVIDED BY 75 = 10 CHILDREN
TOTAL OUTDOOR SPACE = 11254 sq. ft DIVIDED BY 75 = 149 CHILDREN
Measurement was taken 01/03/2008.
Previous random inspection of facility was completed on 01/06/2020

Based on today's inspection, LPA determined that the Room Six (6 )is in compliance with applicable Health & Safety Code and Title 22 Regulations.

Therefore, Licensee was informed the application for Capacity Increase with the addition of room six (6) will be submitted to Licensing Management for final approval.

Exit interview was conducted, where this report was e-mailed to licensee for review.

A NOTICE OF SITE VISIT WAS ISSUED.


SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2020
LIC809 (FAS) - (06/04)
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