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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412013
Report Date: 01/06/2025
Date Signed: 01/06/2025 01:06:52 PM

Document Has Been Signed on 01/06/2025 01:06 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:GILROY UNIFIED SCHOOL DISTRICT ROD KELLEY PRE.FACILITY NUMBER:
434412013
ADMINISTRATOR/
DIRECTOR:		GAYLE DARRFACILITY TYPE:
850
ADDRESS:8755 KERN AVENUETELEPHONE:
(669) 205-4700
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 15DATE:
01/06/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Beatrice MagdalenoTIME VISIT/
INSPECTION COMPLETED:
01:18 PM
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On 1/6/2024, at 12:45 PM, Licensing Program Analyst (LPA) Liridon Fici- Doni arrived unannounced to conduct a case management visit to deliver amended reports dated for 11/6/2024. LPA was greeted by Director, Beatrice Magdaleno and explained the purpose of the visit.

LPA obtained the original report dated for 11/6/2024 and delivered amended report today, dated for 1/6/2025.

No deficiencies cited during visit.

A notice of site visit was given and must remain posted for 30 days.




Exit interview conducted with Licensee, and this report reviewed and provided.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Liridon Fici
LICENSING EVALUATOR SIGNATURE: DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2025
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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