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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414441
Report Date: 09/19/2022
Date Signed: 09/19/2022 05:13:58 PM

Document Has Been Signed on 09/19/2022 05:13 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:EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/PSFACILITY NUMBER:
434414441
ADMINISTRATOR:MY NGUYEN-SOYFACILITY TYPE:
850
ADDRESS:1399 SANTEE DRIVETELEPHONE:
(408) 573-3340
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY: 173TOTAL ENROLLED CHILDREN: 102CENSUS: 75DATE:
09/19/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:53 PM
MET WITH:Elvira CortezTIME COMPLETED:
05:25 PM
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Licensing Program Analyst (LPA), Marilou Monico, met with Site Director, Elvira Cortez, for a Case Management Inspection. Site Director self-reported an alleged incident to Licensing on September 13, 2022. During today's inspection, LPA toured the classrooms, interviewed staff, reviewed camera footage, and obtained copies of documents.

Based on the information gathered during the investigation, there were no deficiencies cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2022
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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