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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274415586
Report Date: 03/28/2024
Date Signed: 03/28/2024 11:13:28 AM

Document Has Been Signed on 03/28/2024 11:13 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KING CITY EARLY EDUCATION & CHILD CARE CENTERFACILITY NUMBER:
274415586
ADMINISTRATOR:FANNY CHAVEZFACILITY TYPE:
850
ADDRESS:525 N. RUSS STREET, ROOMS 6&7TELEPHONE:
(831) 202-1230
CITY:KING CITYSTATE: CAZIP CODE:
93930
CAPACITY: 40TOTAL ENROLLED CHILDREN: 30CENSUS: 25DATE:
03/28/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Maria RodriguezTIME COMPLETED:
09:35 AM
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Licensing Program Analyst (LPA) Fermin Campos-Jaramillo conducted a Plan Of Correction (POC) Inspection to the center today. LPA met with Maria Rodriguez, Site Supervisor and explained the nature of today's visit to her.
LPA observed 25 preschool children were present and six staff members were present providing supervision to the children.
The center was cited with a type A deficiency on 3/13/24. According with the AB633, Site Supervisor was instructed then to inform the parents of the children enrolled and future enrolled and obtain a signed document (Lic9224) for every child enrolled. LPA reviewed the documents and observed that the parents of the 30 children enrolled up to date have signed received the forms Lic9224. Site Supervisor stated there are no new children enrolled at The Center.

Deficiency cited on 3/13/24 is thus cleared today.

No deficiencies were cited today.

Notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2024
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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