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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710539
Report Date: 12/11/2024
Date Signed: 12/11/2024 03:19:46 PM

Document Has Been Signed on 12/11/2024 03:19 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:CHALLENGER SCHOOL-SUNNYVALEFACILITY NUMBER:
430710539
ADMINISTRATOR/
DIRECTOR:		HENRY, JACQUELINEFACILITY TYPE:
850
ADDRESS:1185 HOLLENBECK AVENUETELEPHONE:
(408) 245-7170
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY: 168TOTAL ENROLLED CHILDREN: 19CENSUS: 13DATE:
12/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:04 PM
MET WITH:Kaitlyn Cleary and Minakshi SenTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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Licensing Program Analyst (LPA) Mandeep Kaur, met with head of the school, Kaitlyn Cleary and Regional Director, Minakshi Sen and explained the purpose of the inspection: Case Management- Incident inspection, that was self reported on 12/06/2024.

During today's inspection, LPA interviewed four staff including Head of the school and Regional Director and a child (C1). LPA reviewed three (3) staff files for teachers qualification.

Child Care Facility roster and Personnel report was obtained during today's inspection.

Further investigation is required and the inspection is thus CONTINUING. LPA advised Regional Director that they will reach out for additional details/information regarding this inspection.

No deficiencies issued during todays inspection. Exit interview conducted and report was reviewed with Regional Director, Minakshi Sen.

A NOTICE OF SITE VISIT HAS BEEN GIVEN AND MUST BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/11/2024
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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