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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412013
Report Date: 11/30/2023
Date Signed: 11/30/2023 05:55:01 PM

Document Has Been Signed on 11/30/2023 05:55 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:GILROY UNIFIED SCHOOL DISTRICT ROD KELLEY PRE.FACILITY NUMBER:
434412013
ADMINISTRATOR:GAYLE DARRFACILITY TYPE:
850
ADDRESS:8755 KERN AVENUETELEPHONE:
(669) 205-4700
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 18DATE:
11/30/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:51 AM
MET WITH:Gaylee Darr and Beatrice MagdalenoTIME COMPLETED:
12:33 PM
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Licensing Program Analysts (LPAs) Samantha Yip and Doni Fici conducted an unannounced Case Management-Incident inspection. LPA met with Site Director Gaylee Darr and explained the reason for the inspection. Early Childhood Administrative, Beatrice Magdaleno arrived shortly after. The purpose of this inspection is to review a self-reported incident involving S-1 and C-1 and a potential violation of personal rights.

During today's inspection, LPAs conducted interview with staff, children, and parent. LPAs also reviewed staff and children's files. The center had also conducted their own investigation. Early Childhood Administrative stated that S-1 does not work at this facility. LPAs also reviewed additional information.

Based on insufficient information, no deficiencies were issued. Exit interview conducted and report was reviewed with Early Childhood Administrative, Beatrice Magdaleno. A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
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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