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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415594
Report Date: 11/17/2023
Date Signed: 11/17/2023 11:16:31 AM

Document Has Been Signed on 11/17/2023 11:16 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:PRECIOUS MOMENTS PRESCHOOL LLCFACILITY NUMBER:
434415594
ADMINISTRATOR:THUONG LEFACILITY TYPE:
850
ADDRESS:830 WEST EVELYN AVENUETELEPHONE:
(408) 685-2261
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 24DATE:
11/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Priyanka BansalTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Mel Matos met with Priyanka Bansal, Licensee representative, for an unannounced case management inspection.

LPA toured the Facility and observed 10 toddler children with in the Toddler Room with one teacher and two aides, 8 preschool children in the Orange Room with Thuong Le (director), and 10 preschool children in the Green Room with Priyanka Bansal (director qualified).

LPA reminded Priyanka that the staff-child ratio for the Toddler Room capacity (10 children) is one teacher per 6 toddler children (2 teachers for maximum capacity of 10 toddler children or 1 fully qualified teacher & 1 aide for maximum capacity of 10 toddler children). Priyanka states that she understands the staff-ratio requirement for the Toddler Room.

Exit interview conducted and report was reviewed with the Licensee representative, Priyanka Bansal. No deficiencies issued during today's inspection.

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

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2023
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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