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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709977
Report Date: 03/30/2023
Date Signed: 03/30/2023 11:46:12 AM

Document Has Been Signed on 03/30/2023 11:46 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SJB - NOBLE EXTENDED DAYCAREFACILITY NUMBER:
430709977
ADMINISTRATOR:SALDIVAR, OFELIAFACILITY TYPE:
840
ADDRESS:3466 GROSSMONT DRIVETELEPHONE:
(408) 538-0200
CITY:SAN JOSESTATE: CAZIP CODE:
95132
CAPACITY: 52TOTAL ENROLLED CHILDREN: 52CENSUS: 0DATE:
03/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Ofelia SaldizarTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Pete Hernandez attempted an unannounced Required 1 Year inspection of the School Age Program. LPA met with Site Director Ofelia Saldivar and informed her the purpose of the visit.

The Director just happened to be at this location to do a monthly clean up of the facility. She informed the LPA that this facility location has been inactive since the beginning of Covid-19. She stated that it is unlikely that the site will reopen anytime soon, if ever.The LPA explained that there is no record of CCLD having been notified. LPA was able to talk to the Regional Director Laura Behl over the Directors's phone. She stated that she took over the position after this facility had already went inactive and does not know why CCLD was not ever notified. LPA offered to provide a Request For Inactive Child Care Form. She was grateful and the LPA left a copy with the Director to pass on to Laura.

No regulatory violations were observed since there was no inspection performed at the time of the visit. Exit interview was conducted, where this report was reviewed with Site Director.

A NOTICE OF SITE VISIT WAS ISSUE AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023
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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