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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710539
Report Date: 03/17/2025
Date Signed: 03/17/2025 11:19:58 AM

Document Has Been Signed on 03/17/2025 11:19 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 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: 82CENSUS: 78DATE:
03/17/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:01 AM
MET WITH:Denise ReidTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA) Mandeep Kaur, met with Director, Denise Reid and explained the purpose of the investigation: continuation of the Case Management- Incident investigation, that was self reported on 02/26/2025. LPA conducted incident investigation comprising of interviews with staff, Parents and children and observations.

During today's investigation, LPA interviewed three (3) staff (S1,S2&S3), Director and two(2) children (C1& C2).

Based on interviews and observations, department concludes that there was no lack of supervision or no personal rights were violated as result of the incident noted above.

No deficiency issued during today's investigation.

Exit interview conducted, report was reviewed with Director, Denise Reid.

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: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2025
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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