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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415610
Report Date: 06/27/2024
Date Signed: 06/27/2024 02:06:46 PM


Document Has Been Signed on 06/27/2024 02:06 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:SHANAM SAINIFACILITY TYPE:
850
ADDRESS:260 SOUTH MARY AVENUETELEPHONE:
(408) 746-5666
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:30CENSUS: 15DATE:
06/27/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Faith Martinez-IyerTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Mel Matos met with Faith Martinez-Iyer, teacher, for an unannounced case management inspection.

Shanam Saini, Licensee representative/director, was at a doctor's appointment and thus was not present during today's inspection.

LPA advised Faith that the Facility will need to consult with the local fire department prior to applying with the Department if they wish to add a "toddler component" for children ages 18-36 months in the future.

Note: There have been some updates to the state building codes since 2023 which could affect the occupancy class for any facility adding a "new component" to its existing license. Otherwise, the occupancy class remains as is if there are no changes to the existing license.

Exit interview conducted and report was reviewed with the teacher, Faith Martinez-Iyer. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Belinda DevallTELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:
DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2024
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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