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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414738
Report Date: 05/17/2024
Date Signed: 05/17/2024 09:41:48 AM

Document Has Been Signed on 05/17/2024 09:41 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:BUTTERFLIES ACADEMY, INCFACILITY NUMBER:
434414738
ADMINISTRATOR/
DIRECTOR:		AZARCHEHR, FARINAZFACILITY TYPE:
850
ADDRESS:14103 SARATOGA AVE.TELEPHONE:
(408) 867-3772
CITY:SARATOGASTATE: CAZIP CODE:
95070
CAPACITY: 30TOTAL ENROLLED CHILDREN: 29CENSUS: 17DATE:
05/17/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:08 AM
MET WITH:Farinaz AzarchehrTIME VISIT/
INSPECTION COMPLETED:
09:50 AM
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Licensing Program Analyst (LPA) Marilou Monico conducted a Case Management inspection to verify if S-1 is working at the facility. LPA met with Site Director/Owner, Farinaz Azarchehr, and discussed the purpose of today's visit. Site Director/Owner was interviewed and she stated that S-1 left the center in 2021 to work someplace else.

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: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2024
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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