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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412405
Report Date: 07/20/2023
Date Signed: 07/21/2023 09:06:06 AM


Document Has Been Signed on 07/21/2023 09:06 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:GOOMER ACADEMYFACILITY NUMBER:
434412405
ADMINISTRATOR:DEEPTI GOOMERFACILITY TYPE:
850
ADDRESS:2920 FOWLER ROADTELEPHONE:
(408) 270-2000
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY:74CENSUS: 49DATE:
07/20/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:32 AM
MET WITH:Deepti GoomerTIME COMPLETED:
10:00 AM
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On 07/20/2023, Licensing Program Analysts (LPAs), Farida Raja and Marilou Monico met with Director, Deepti Goomer to conduct an unannounced case management visit. The purpose of the visit is to evaluate the Licensee's request for an addition of a Toddler Component to the Preschool Program. Days and Hours of operation are Monday-Friday, 7am-6pm.

LPAs toured the facility both indoors and outdoors with Director. Present today were 49 preschool children in Rooms 1,2 and 3 and 8 teachers including the director. LPAs discussed the addition of the toddler component in Room 1 and requirements of toddler space both indoors and outdoors. After discussions with Director regarding inside and outside space and bathroom requirements, Director stated that she would like to withdraw her application for the addition of a toddler component to the preschool license.

Director provided LPAs with an application withdrawal letter and submitted an updated Application for Childcare Center License (LIC 200A).

As a result of today's inspection, there were no deficiencies cited.

Exit interview conducted and report was reviewed with the Director, Deepti Goomer.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida RajaTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2023
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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