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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415594
Report Date: 08/16/2024
Date Signed: 08/16/2024 10:08:57 AM

Document Has Been Signed on 08/16/2024 10:08 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:PRECIOUS MOMENTS PRESCHOOL LLCFACILITY NUMBER:
434415594
ADMINISTRATOR/
DIRECTOR:		THUONG LEFACILITY TYPE:
850
ADDRESS:830 WEST EVELYN AVENUETELEPHONE:
(408) 685-2261
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 30TOTAL ENROLLED CHILDREN: 18CENSUS: 17DATE:
08/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Thuong LeTIME VISIT/
INSPECTION COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Mel Matos met with Thuong Le, Director, for an unannounced case management inspection.

LPA toured the Facility and observed 7 toddler children with one teacher & one aide in the Toddler Room (Brown Room) and 10 preschool children in the Orange Room with Thuong Le, Director.

LPA spoke with Priyanka Bansal, Licensee representative, via telephone during today's inspection and reminded her that milk served to the children must be 0% or fat free.

Exit interview conducted and report was reviewed with the Director, Thuong Le.

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

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2024
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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