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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415767
Report Date: 03/22/2024
Date Signed: 03/22/2024 10:26:45 AM

Document Has Been Signed on 03/22/2024 10:26 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:CHILDREN'S COURTYARD, THEFACILITY NUMBER:
434415767
ADMINISTRATOR:ANNABELLE CALASANZFACILITY TYPE:
850
ADDRESS:610 E DUNNE AVENUETELEPHONE:
(408) 778-1977
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 14DATE:
03/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:ANNABELLE CALASANZTIME COMPLETED:
10:20 AM
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On 3/22/2024, at 10:15 AM, Licensing Program Analyst (LPA) Doni Fici arrived unannounced to conduct a case management visit to deliver amended reports dated for 3/5/2024. LPA was greeted by Director, ANNABELLE CALASANZ and explained the purpose of the visit.

LPA obtained the original report dated for 3/5/2024 and delivered amended report today, dated for 3/22/2024.

No deficiencies cited during visit.

Exit interview conducted with Director, and this report reviewed and provided.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Liridon Fici
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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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