434410625-7-30-2025-52-CC-CURE-DK3UKZ-20250730153957

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410625
Report Date: 07/30/2025
Date Signed: 07/30/2025 03:40:08 PM

Document Has Been Signed on 07/30/2025 03:40 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	ST. SIMON PRESCHOOL		FACILITY NUMBER:	434410625
ADMINISTRATOR/ DIRECTOR:	VICKI KESTLER		FACILITY TYPE:	850
ADDRESS:	1840 GRANT ROAD		TELEPHONE:	(650) 967-3293
CITY:	LOS ALTOS	STATE: CA	ZIP CODE:	94024
CAPACITY: 51	TOTAL ENROLLED CHILDREN: 51	CENSUS: 0	DATE:	07/30/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:35 AM
MET WITH:	Vicki Kestler		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 07/30/2025 at 11:35am, Licensing Program Analysts (LPAs) Christina Uribe & Morgan Pringle conducted an unannounced Case Management visit and met with site director and applicant, Vicki Kestler. No other staff or children were present at the time of today's visit as the center is closed for summer break. The facility currently operates Monday-Friday from 7:30am-5:30pm during the school year. The purpose of today's visit is to conduct a health and safety inspection for an increase of capacity application. The facility currently operates out of two (2) classrooms with a capacity of 51. The application submitted requests the addition of one (1) classroom with an increase of capacity of 15 to make a total of 66. LPAs inspected the requested room to be added to the license, which is also used as the library to the K-8 school located on the same campus. The director requests this room to be added to the license to be used as a third classroom from 7:30am to 12:00pm each day. The room to be added has central heating and ventilation for safety and comfort. There is one bathroom located in the hallway just outside of the classroom door that has one (1) toilet and one (1) sink. Furniture and equipment are age appropriate and in good repair. Classroom Measurements: LPAs measured the one (1) classroom which contains a total measurement of 854.71 square feet which will accommodate the application request for 15 preschool children. Page 1 of 2 *Continued on LIC 809C*

NAME OF LICENSING PROGRAM MANAGER: Chandra Charles
NAME OF LICENSING PROGRAM ANALYST: Christina Uribe
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: ST. SIMON PRESCHOOL	FACILITY NUMBER: 434410625
	VISIT DATE: 07/30/2025

NARRATIVE

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There is an outdoor play area located outside of the new classroom which is located through a hallway past administrative offices of the K-8 school. The outdoor play area is fenced with a chain link fence and the church building wall that are at least four feet tall. There are no bodies of water on the premises. There is a shaded area that includes an extended roof to cover the area. Playground is free of debris and other hazards.

Outdoor Play Area Measurements: LPAs measured the one (1) outdoor play area which contains a total measurement of 939.52 square feet which will accommodate 12 preschool children. The director must apply for a waiver to accommodate the request for an increase of 15 children for this outdoor play area use.

Individual measurements for the indoor and outdoor areas are documented on a separate Detail Supportive Information (LIC 812) page.

Application Approval: The request to license the school library as an additional classroom to be used for the preschool program is hereby granted. Additionally, the request to increase the capacity from 51 children to 66 children is hereby granted. The added room is approved to accommodate 15 children and the added outdoor play area is approved to accommodate 12 children.

A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with the director, Vicki Keslter.

Page 2 of 2 ***End of Report***

NAME OF LICENSING PROGRAM MANAGER: Chandra Charles
NAME OF LICENSING PROGRAM ANALYST: Christina Uribe
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025

LIC809 (FAS) - (06/04)

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