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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
434404443
Report Date:
09/19/2024
Date Signed:
09/19/2024 03:29:29 PM
Document Has Been Signed on
09/19/2024 03:29 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
CCLD Regional Office
,
2580 N FIRST STREET, STE. 300
SAN JOSE
,
CA
95131
FACILITY NAME:
TEMPLE EMANU-EL PRESCHOOL
FACILITY NUMBER:
434404443
ADMINISTRATOR/
DIRECTOR:
SMEAD, BARBARA
FACILITY TYPE:
850
ADDRESS:
1010 UNIVERSITY AVENUE
TELEPHONE:
(408) 293-8660
CITY:
SAN JOSE
STATE:
CA
ZIP CODE:
95126
CAPACITY:
90
TOTAL ENROLLED CHILDREN:
90
CENSUS:
55
DATE:
09/19/2024
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
01:37 PM
MET WITH:
Barbara Smead
TIME VISIT/
INSPECTION COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management- Other inspection. LPA met with Director Barbara Smead and explained the reason for the inspection. The purpose of this inspection is to deliver the amended 809 dated 05/31/2024.
No deficiencies were issued as a result of this inspection. Exit interview conducted and report was reviewed with Director Barbara Smead. A notice of site visit has been issued and must posted for 30 days.
SUPERVISORS NAME
:
Joel Segura
LICENSING EVALUATOR NAME
:
Samantha Yip
LICENSING EVALUATOR SIGNATURE
:
DATE:
09/19/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
09/19/2024
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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