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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416367
Report Date: 05/24/2022
Date Signed: 06/28/2022 09:35:22 AM

Document Has Been Signed on 06/28/2022 09:35 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:OVER THE RAINBOW MONTESSORIFACILITY NUMBER:
434416367
ADMINISTRATOR:VARSHA DEODIKARFACILITY TYPE:
850
ADDRESS:880 HILLSDALE AVENUETELEPHONE:
(408) 691-7621
CITY:SAN JOSESTATE: CAZIP CODE:
95136
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: DATE:
05/24/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Ravi Prakash and Sheetal PrakashTIME COMPLETED:
11:45 AM
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Office meeting with Ravi Prakash and Sheetal Prakash to review application for change of ownership. The following items need correction prior to the license being granted.

1. Need a board for application, appointing liaison, appoint facility director.
2. LIC 401 no total expenses for the month LIne 37.
3. LIC 404 balance is $29,754 need $74,670 submit new LIC 404. Add more $$ to bank account.
4. LIC 610 missing location of first aid kit.
5. LIC 999 missing utility shut offs, rename office
6. Lease needs to be between landlord and Prakash Empires LLC
7. Job descriptions for director and teacher
8. Staff handbook corrections needed.
9. Admission Agreement corrections needed.
10. Parent Handbook corrections needed.
11. Menus need portion sizes
12. Director needs updated health screening
13. Fire clearance needed
14. Prelicensing inspection.

Applicants to submit corrections by June 6, 2022.
SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Mary Segura
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2022
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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