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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710441
Report Date: 11/07/2024
Date Signed: 11/08/2024 10:42:09 AM

Document Has Been Signed on 11/08/2024 10:42 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:ROULEAU HEAD STARTFACILITY NUMBER:
430710441
ADMINISTRATOR/
DIRECTOR:		CUC TRANFACILITY TYPE:
850
ADDRESS:1875 MONROVIA DRIVETELEPHONE:
(408) 573-4717
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY: 105TOTAL ENROLLED CHILDREN: 52CENSUS: 41DATE:
11/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Rocio LitleTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On 11/07/2024 at 10:50am, Licensing Program Analyst (LPA) Farida Raja met with Director, Rocio Litle and conducted an unannounced Case Management inspection in response to an unusual incident that occurred on October 3rd, 2024 involving two preschool age children (C1 and C2). Incident was self reported by the facility to Licensing on October 4th 2024.

LPA observed 41 children and 7 staff within the three classrooms toured at the facility during today's inspection. Based on interview with Director, Director stated that their Human Resources investigation is complete. Director stated that they are unable to provide a report to Licensing as their investigation is confidential but stated that the findings were unfounded for both incidents. Director stated that staff (S1) involved in the incident has returned to work at the facility.

Based on the available evidence and interviews no violations were cited.

Exit interview conducted and the report was reviewed with the Director, Rocio Litle.

A notice of site visit was issued and must remain posted for 30 days.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2024
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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