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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416685
Report Date: 06/06/2022
Date Signed: 06/06/2022 01:25:15 PM


Document Has Been Signed on 06/06/2022 01:25 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:SECRET GARDEN PRESCHOOL, THEFACILITY NUMBER:
444416685
ADMINISTRATOR:ALYSSA NUNEZFACILITY TYPE:
850
ADDRESS:26 FLORIDO AVENUETELEPHONE:
(801) 652-4417
CITY:LA SELVA BEACHSTATE: CAZIP CODE:
95076
CAPACITY:39CENSUS: 28DATE:
06/06/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Olesya Kalinowska TIME COMPLETED:
12:10 PM
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Amendment:
Case Management - Other inspection
The Secret Garden Preschool # 444416685
AMENDED ON 6/6/2022 original documented 5/20/2022

Census on 6/6/2022: 6 staff 28 children
Licensing Program Analysts (LPA) Stephanie Collins conducted a case management. The purpose of the visit is to amend and clarify outdoor measurements. LPA met owner Olesya Kalinowska and explained the purpose of the visit.

The following corrections and updates were required :

1: Number of staff and children observed,
3: Playground sq. ft.
4: Number of staff rest rooms (# toilets and # sinks) available to staff.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:
DATE: 06/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/06/2022
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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