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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274404305
Report Date: 09/10/2026
Date Signed: 09/10/2026 02:18:22 PM

Document Has Been Signed on 09/10/2026 02:18 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MADONNA DEL SASSO PRESCHOOLFACILITY NUMBER:
274404305
ADMINISTRATOR/
DIRECTOR:		MALLELY DE LA CRUZFACILITY TYPE:
850
ADDRESS:20 SANTA TERESA WAYTELEPHONE:
(831) 424-7813
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 19DATE:
09/10/2026
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Yvonne Politron - Facility RepresentativeTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On 09/10/2026, Licensing Program Analysts (LPAs), Jennifer “Jen” Beehler and Diana DeLeon conducted an unannounced 3 Year Required inspection. Upon arrival, LPAs were greeted by the school Principal Mr. Evans and was taken to the Preschool Classroom. The Acting Director, Yvonne Politron was present and provided access to the facility. LPAs provided the reason for the visit, toured the facility and collected the census. There were 19 children (preschool-age) and four (4) staff (4-teachers) present, which is compliant with the facility license capacity and ratio requirements. LPAs observed all required postings near the entrance to the facility. Hours of operation for the facility are Monday – Friday, 08:00AM-4:30PM. The facility has an active waiver to share the bathroom with the elementary school.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

All staff present had criminal record clearance and were associated to the roster on Guardian.

LPA reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. Sign-in/out was observed to be incomplete with a few entries missing the full legal signature or time of day.


Continued on Page 2
Adam Hamer
Jennifer Beehler
DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 09/10/2026 02:18 PM - It Cannot Be Edited


Created By: Jennifer Beehler On 09/10/2026 at 12:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MADONNA DEL SASSO PRESCHOOL
FACILITY NUMBER: 274404305

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(n)
Fixtures, Furniture, Equipment and Supplies
(n) Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observations, the licensee's outdoor play area has areas of disrepair that pose a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/24/2026
Plan of Correction
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Facility to provide the Department with a written plan to address the disrepair on the outdoor play area.
Type B
Section Cited
CCR
101239(f)(1)
Fixtures, Furniture, Equipment and Supplies
(f) Solid waste shall be stored, located and disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or provide a breeding place or food source for insects or rodents. (1) All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observations, the outdoor trash can did not have a tight fitted lid which allows for loose trash and debris to litter the play ground. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/24/2026
Plan of Correction
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Licensee to replace the trash can with one that has a tight fitted lid and to remove all trash and debris from the play area. Licensee to provide proof to the Department by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Adam Hamer
NAME OF LICENSING PROGRAM MANAGER:
Jennifer Beehler
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2026


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Document Has Been Signed on 09/10/2026 02:18 PM - It Cannot Be Edited


Created By: Jennifer Beehler On 09/10/2026 at 12:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MADONNA DEL SASSO PRESCHOOL
FACILITY NUMBER: 274404305

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(o)(1)
Fixtures, Furniture, Equipment and Supplies
(o) Playground equipment shall be securely anchored to the ground unless it is portable by design. (1) Equipment shall be maintained in a safe condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observations, some outdoor play equipment was not bolted and had parts that were coming a part. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/24/2026
Plan of Correction
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Licensee to repair or bolt any equipment used for children on the play area and to send proof to the Department by POC due date.
Type B
Section Cited
CCR
101229(a)
Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observations, children were observed in areas that are designated as off limits, climbing on the diaper table and out of visual supervision of staff. Lack of supervision poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/24/2026
Plan of Correction
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Licensee to provide a written plan on the protocol for supervision of children in care by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Adam Hamer
NAME OF LICENSING PROGRAM MANAGER:
Jennifer Beehler
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2026


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Document Has Been Signed on 09/10/2026 02:18 PM - It Cannot Be Edited


Created By: Jennifer Beehler On 09/10/2026 at 12:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MADONNA DEL SASSO PRESCHOOL
FACILITY NUMBER: 274404305

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101217(d)
Personnel Records
(d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 4 out of 4 files. Staff files were incomplete which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/24/2026
Plan of Correction
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Facility Representative to review file requirements and collect all required documents for staff files. Licensee to provide a written plan to ensure future compliance by POC due date.
Type B
Section Cited
CCR
101229.1(a)(1)
Sign In and Sign Out
(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as some signatures and time of day were missed on the sign in/out log. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/24/2026
Plan of Correction
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Licensee to provide a written plan on how to ensure compliance by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Adam Hamer
NAME OF LICENSING PROGRAM MANAGER:
Jennifer Beehler
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/10/2026 02:18 PM - It Cannot Be Edited


Created By: Jennifer Beehler On 09/10/2026 at 12:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MADONNA DEL SASSO PRESCHOOL
FACILITY NUMBER: 274404305

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101212(b)
Reporting Requirements
(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs Observation, the facility has a new Director and the Department was not notified within 10 days. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/24/2026
Plan of Correction
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Facility Representative to provide the required documents and certifications outstanding to fully qualify as the facility Director. Licensee to provide written plan on how to maintain compliance by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Adam Hamer
NAME OF LICENSING PROGRAM MANAGER:
Jennifer Beehler
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2026


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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MADONNA DEL SASSO PRESCHOOL
FACILITY NUMBER: 274404305
VISIT DATE: 09/10/2026
NARRATIVE
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The last fire/disaster drill was conducted on 08/14/2026, which is compliant with the six month requirement for facilities. LPAs observed a fully charged 3A40BC fire extinguisher last serviced 07/10/2026, which is compliant with state fire marshal regulations. LPAs observed a fully functioning smoke detector system and a working carbon monoxide detector. Facility Representative states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Indoor areas of the facility were inspected by the LPAs today and observed to be clean and orderly. LPAs observed room partitions that were not attached and were unstable. LPAs observed sufficient age-appropriate materials, toys, and play equipment in the facility. Furniture, such as tables, chairs, and shelves, are in good condition and safe for children. The floors were clean and free of tripping hazards. Staff and children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom, not utilized by the children, which an isolated child can use if necessary. The Facility Representative states a working landline is designated for the facility. Cleaning and maintenance for the facility is conducted by an outside service and is completed in the evenings after all day care children have left the premises. The Facility Representative states that there are no weapons or firearms on the premises.

The outdoor area of the facility was inspected and observed to be fenced in. LPAs observed play equipment was age-appropriate. LPAs observed some play equipment had tears with jagged edges, some metal parts were rusted with equipment that was not bolted or mounted in some cases. There was tanbark present but there was not a sufficient amount of tanbark below the swings. LPAs observed the rubber mats under the large play structure had warped and was creating tripping hazards. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy and trees.

Continued on Page 3
NAME OF LICENSING PROGRAM MANAGER: Adam Hamer
NAME OF LICENSING PROGRAM ANALYST: Jennifer Beehler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
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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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MADONNA DEL SASSO PRESCHOOL
FACILITY NUMBER: 274404305
VISIT DATE: 09/10/2026
NARRATIVE
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Children bring food from home along with reusable water bottles filled with water. The facility has bottled water available to refill children's water bottles. Facility does not use the water faucets for food preparation or for children to drink. The facility provided a written attestation to confirm untested water is not provided to children in care.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

Five (5) children’s files (preschool-age) were reviewed during today’s inspection for the following records: Physician’s Report (LIC701), Notification of Parents Rights (LIC995A), Personal Rights (LIC613A), Consent for Emergency Medical Treatment (LIC627), Identification and Emergency Information (LIC700), Signed Admission Agreement, and Immunization Records (PM286). LPAs observed all files to be complete.

Four (4) staff files (1-acting director/3-teachers) were reviewed for the following records: Transcripts/Verification of Experience, Health Screening Report (LIC503), Employee Rights (LIC9052), Criminal Record Statement (LIC508), Statement Acknowledging Requirement to report Child Abuse (LIC9108), Mandated Reporter Training Certificate, Tuberculosis (TB) Clearance, and Immunization Record showing immunity to measles (MMR), pertussis (Tdap), and influenza or statement declining influenza. LPAs observed the staff files to be incomplete. There is at least one staff member present with current CPR/First-Aid that expires 06/2027. The Facility Representative did not complete the correct Mandated Reporter Course that meets the requirement for AB1207. LPAs reminded the Facility Representative that Mandated Reporter must be renewed every two years. The course can be completed at www.mandatedreporterca.com.

LPAs observed a child in the off limits area of the preschool classroom climbing on the diaper changing table. LPAs observed a room partition falling over in the room and unstable. LPAs observed instances where children were not visually observed by staff.

Continued on Page 4
NAME OF LICENSING PROGRAM MANAGER: Adam Hamer
NAME OF LICENSING PROGRAM ANALYST: Jennifer Beehler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MADONNA DEL SASSO PRESCHOOL
FACILITY NUMBER: 274404305
VISIT DATE: 09/10/2026
NARRATIVE
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The Facility representative understands that the site director shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPAs reminded Facility Representative that there shall be at least one person with valid EMSA approved CPR and First-Aid certifications on site at all times or present during off site activities, such as field trips. EMSA approved courses can be located at the following website: https://www.emsa.ca.gov

LPAs reminded the Facility Representative that the Department must be notified within 10 days when a Director change is made.

During today's visit, LPAs reviewed the Acting Director's file and observed it to be complete with the exception of the following items:

1. The completion of the Administration course, which will be completed in October.
2. The issuance of the Preventative Health and Safety Course Certificate.
3. Experience letters

During today's visit, the following documents were collected:
1. Updated LIC610 - Emergency Disaster Plan
2. Letter of Attestation for Lead Testing
3. Updated LIC200A changing the Director to Yvonne
4. Update Facility Sketch

LPAs will reach out to the Technical Support service and request a representative reach out to the facility for additional training.

As a result of this inspection, seven (7) Type B Deficiencies along with a Technical Violation are cited. More details are provided in the attached supporting documents. Exit interview conducted with the Facility Representative. Report was reviewed and provided to the Facility Representative, Yvonne Politron along with appeal rights.

Continued on Page 5
NAME OF LICENSING PROGRAM MANAGER: Adam Hamer
NAME OF LICENSING PROGRAM ANALYST: Jennifer Beehler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MADONNA DEL SASSO PRESCHOOL
FACILITY NUMBER: 274404305
VISIT DATE: 09/10/2026
NARRATIVE
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A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
NAME OF LICENSING PROGRAM MANAGER: Adam Hamer
NAME OF LICENSING PROGRAM ANALYST: Jennifer Beehler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC809 (FAS) - (06/04)
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