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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709674
Report Date: 07/18/2023
Date Signed: 07/18/2023 12:58:35 PM

Document Has Been Signed on 07/18/2023 12:58 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:HEADSUP CHILD DEVELOPMENT CENTERFACILITY NUMBER:
430709674
ADMINISTRATOR:RONA NUNEZFACILITY TYPE:
850
ADDRESS:2841 JUNCTION AVENUETELEPHONE:
(408) 432-1644
CITY:SAN JOSESTATE: CAZIP CODE:
95134
CAPACITY: 72TOTAL ENROLLED CHILDREN: 30CENSUS: 23DATE:
07/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Rona NunezTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Mel Matos met with Rona Nunez, Director, for an unannounced case management inspection. LPA observed four teachers with 23 preschool children in the Facility during today's inspection.

LPA discussed the teacher child ratios with Rona during today's inspection. LPA notes that the Facility also has an infant license (#430709672) on the same premises. Director states that she understands the ratio requirements for both licenses.

LPA reminded Director that staff must be associated to each license/program that they are working in, regardless if it is only on a temporary basis.

Exit interview conducted and report was reviewed with the Licensee, Rona Nunez. No deficiencies issued during today's inspection.

A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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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