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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709587
Report Date: 01/23/2023
Date Signed: 01/23/2023 03:08:49 PM

Document Has Been Signed on 01/23/2023 03:08 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:YMCA-REEDFACILITY NUMBER:
430709587
ADMINISTRATOR:KERYN NORTHERNERFACILITY TYPE:
840
ADDRESS:1524 JACOB AVENUETELEPHONE:
(408) 978-3002
CITY:SAN JOSESTATE: CAZIP CODE:
95118
CAPACITY: 98TOTAL ENROLLED CHILDREN: 51CENSUS: 0DATE:
01/23/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:PAUL CARRTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Kassandra Medrano met with Site Supervisor, Paul Carr and Audrey Voss, Program Director for a case management inspection. Purpose of today's inspection: reduction of room usage and licensed capacity. LPA explained the nature of today's inspection to Paul and Audrey, together toured the indoor and outdoor areas of the facility during today's inspection.
The current Facility is located on the campus of Reed Elementary School (under the San Jose Unified School District). The Facility is currently licensed in Portables: E-6, E-7, E-8. The San Jose Unified School District has renamed the Portables - what was previously YMCA portables is now E-7 and E-8. The Facility has requested to remove Portable E-6 from the license. The licensed capacity will reduce from 98 school age children to 70 school age children in Portables: E-7 and E-8.

The Facility operates at a functioning elementary school site and thus is exempt from the indoor and outdoor square footage requirements, fencing requirements, and toilet/sink ratios and isolation area requirements.

A capacity letter from the San Jose Unified School District listing the maximum capacity for E-7 and E-8 of 35 children per classroom totaling in 70 children total was received prior to today's inspection. A fire clearance approval for E-7 and E-8 was also received from the San Jose Fire Department prior to today's inspection, on 12/19/2020.

LPAs conducted an exit interview with Paul and Audrey and advised them that a license for 70 school age children in Room E-7 and E-8 is approved today, January 23, 2023.

No deficiencies issued during today's inspection. Notice of site visit issued and must remain posted for 30 days.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2023
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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