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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444415707
Report Date: 05/18/2023
Date Signed: 05/18/2023 11:36:05 AM


Document Has Been Signed on 05/18/2023 11:36 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:CAMPUS KIDS CONNECTION, VALENCIAFACILITY NUMBER:
444415707
ADMINISTRATOR:ANNIE SAGEFACILITY TYPE:
840
ADDRESS:250 APTOS SCHOOL ROADTELEPHONE:
(831) 465-4192
CITY:APTOSSTATE: CAZIP CODE:
95003
CAPACITY:80CENSUS: 0DATE:
05/18/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Noel ArbabaraghiTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Joe Macias conducted a Case Management/ Increase of Capacity Inspection. LPA Macias met with the Executive Director Noel Arbabaraghi and explained the nature of today's inspection. The purpose of today’s visit is to ensure the facility is in compliance with Title 22 California Code of Regulations. The facility is located on the Valencia Elementary School campus. The school age program is currently licensed in rooms #32, and #33, with access to the cafeteria. The current maximum capacity is 80. The Director recently submitted an application for the purpose of an increase of capacity. Campus Kids Connection Valencia is requesting a capacity increase to provide care and supervision for up to 250 children. The hours of operation are Monday - Friday, 12pm - 6pm. The facility has an active waiver allowing all employees to be associated to Westlake CKC INC. #440710576.

LPA Macias toured all indoor and outdoor activity spaces, the playgrounds and structures, restrooms, cafeteria, and the library during todays inspection. Prior to today's visit LPA Macias received an approved fire clearance from the Aptos Fire Prevention Department. To accommodate the increase, the facility has added rooms #22, #30, #34, #35, as well as access to the library. No measurements were taken, as the school has provided a capacity letter. LPA observed that all rooms are in order. Drinking water is readily available for the children in each room and in the outdoor playground area via water dispensers, and cups. The facility exclusively utilizes filtered water for drinking, and food services. The Director has submitted proof of the required lead testing. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean and sanitary.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing. LPA observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, and no bodies of water.

No deficiencies cited, exit interview conducted and report was reviewed with the Executive Director Noel Arbabaraghi. LPA Macias explained that the increase of capacity will be granted pending management approval.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023
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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