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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415610
Report Date: 09/18/2024
Date Signed: 09/18/2024 04:13:43 PM

Document Has Been Signed on 09/18/2024 04:13 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:WINDSOR PRESCHOOL-SUNNYVALEFACILITY NUMBER:
434415610
ADMINISTRATOR/
DIRECTOR:		SHANAM SAINIFACILITY TYPE:
850
ADDRESS:260 SOUTH MARY AVENUETELEPHONE:
(408) 746-5666
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 30TOTAL ENROLLED CHILDREN: 20CENSUS: 20DATE:
09/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Shanam SainiTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Mel Matos met with Shanam Saini, Licensee Representative/Director, for an unannounced case management inspection. LPA also observed two teachers with 20 preschool children in the Facility during today's inspection.

Shanam understands that here have been some updates to the state building codes since 2023 which could affect the occupancy class for any facility adding a "new component or changes" to its existing license. Shanam states that she will consult with the local fire marshal if she has any additional questions.

Shanam agreed to submit an updated Personnel Report (LIC 500) and Emergency Disaster Plan (LIC 610) to LPA Matos by Friday September 27, 2024.

Exit interview conducted and report was reviewed with the Licensee Representative/Director, Shanam Saini. No deficiencies issued during today's inspection.

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: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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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