430710486-8-27-2025-07-CC-AMOS-DKXQES-20250827120650

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710486
Report Date: 08/27/2025
Date Signed: 08/27/2025 12:08:26 PM

Document Has Been Signed on 08/27/2025 12:08 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	WOOL CREEK HEAD START		FACILITY NUMBER:	430710486
ADMINISTRATOR/ DIRECTOR:	SANDY MCKEITHAN		FACILITY TYPE:	850
ADDRESS:	645 WOOL CREEK DRIVE		TELEPHONE:	(408) 573-4091
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY: 74	TOTAL ENROLLED CHILDREN: 0	CENSUS: 22	DATE:	08/27/2025
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:45 AM
MET WITH:	Cuc Tran, Site Director		TIME VISIT/ INSPECTION COMPLETED:	10:15 AM

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Licensing Program Analyst (LPA) Anna Morales conducted an unannounced Case Management Inspection. LPA met with Site Director Cuc Tran. The Facility has requested an application to decrease the capacity from 74 to 48. The facility has closed Room 2 and will use only Classrooms # 3 and #4. Fire Clearance was granted on 5/27/2008 for Classrooms, #3 and #4.

The hours of operation will continue to be Monday- Friday, 8:15AM -2:15PM, ages 2.9 years to entry to kindergarten. During today's visit, LPA toured the building and grounds:

Indoor measurements are as follows per LPA Mliagros Aguas, 6/6/2008:

ROOM 3: 39.249 x 27.249 = 1,069.496 minus 22 (encumbered space) = 1,047.496

ROOM 4: 39.249 x 26.581 = 1,043.277 minus 22 (encumbered space) = 1,021.277

TOTAL PRESCHOOL INDOOR SPACE: (Rm #3) 1,047.496) +1,021.277(Room 4)=2,068.773 divided by 35 sq.ft.=59 children

OUTDOORS

118.664 x 97.498 = 11,569.502 - 272 (encumbered space) = 11, 297.502
82.249 x 9.747 = 801.681
22.589 x 5.249 = 118.569
23.664 x 22.249 = 526.500
15.913 x 23.664 / 2 = 118.282
TOTAL OUTDOOR SPACE: 12,862.534 sq. ft. - divided by 75 = 171 children. Playground is enclosed with a 5 ft fence and has a canopy and trees for shades.
LPA observed a total of 6 sinks and 5 toilets, 42 cots, 13 tables and 64 chairs. There is a bathroom for staff and for children who are sick. Sick children will be isolated in the Office and isolation equipment is provided.

Exit interview was conducted. No deficiencies were cited at today's visit. Appeal Rights given. A Notice of Site Visit was issued and advised Director to post in a visible location for 30 days.

LPA will update License to reflect changes made to the capacity from 74 to 48 children.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Anna Morales
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/27/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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