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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416410
Report Date: 10/01/2021
Date Signed: 10/11/2021 05:05:09 PM

Document Has Been Signed on 10/11/2021 05:05 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SAN JOSE MONTESSORI, L.L.C.FACILITY NUMBER:
434416410
ADMINISTRATOR:SUSAN FERNANDEZFACILITY TYPE:
850
ADDRESS:979 MERIDIAN AVENUETELEPHONE:
(408) 377-9888
CITY:SAN JOSESTATE: CAZIP CODE:
95126
CAPACITY: 36TOTAL ENROLLED CHILDREN: 48CENSUS: 23DATE:
10/01/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Susan FernandezTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Dung Mac conducted an unannounced case management inspection to the Facility today in response to Facility’s request to increase capacity from 36 to 48 children. A Fire Clearance has been granted for the increase on 9/14/2021.

LPA met with Susan Fernandez, Site Director, and explained the nature of today's visit. Present at the facility were 23 preschool children. The hours of operation are Monday-Friday 7:30AM-4:30PM, serving children 2 years to entry into first grade.

Director states that there were no changes to the classroom layouts since the pre-licensing inspection on 1/30/2020; therefore, the indoor space was not measured during today's tele-inspection.

INDOOR MEASUREMENTS:

Room 1 = 945.903 minus 51.982 (encumbered space) = 893.921 sq. ft.
Room 2 = 904.303 minus 50.818 (encumbered space) = 853.485 sq. ft.

TOTAL INDOOR ACTIVITY SPACE =1747.406 sq. ft. divided by 35 = 49 children

There are 4 toilets (60) and 6 sinks (90) available for children to use. LPA observed 23 tables, 50 chairs, 48 cubbies, and 50 mats. Site Director states that there is only cold water available in children's sinks. LPA observed dispenser soap and disposable towels in the bathrooms. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed.
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SAN JOSE MONTESSORI, L.L.C.
FACILITY NUMBER: 434416410
VISIT DATE: 10/01/2021
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Sick children are isolated in Director's office and isolation equipment is provided. Drinking water indoors is available via individual water bottles and pitchers.

Playground is completely surrounded by appropriate fencing. Shade is provided by the building overhangs. Areas around climbing structures have resilient materials to absorb falls. Drinking water outdoors are provided via water fountains. No bodies of water and no storages/sheds were observed during today's inspection. Landscaping area is off-limit to children.

Director states that there were no changes to the layouts of the playgrounds since last inspection on 1/30/2020; therefore, the outdoor space was not measured during today's inspection.

OUTDOOR MEASUREMENTS:

4150.195 minus encumbered space 8.066 = 4142.129 sq. ft.

TOTAL OUTDOOR SPACE = 4142.129 sq. ft. divided by 75 = 55 children

Notice of Site Visit was issued. LPA conducted an exit interview and advised Site Director that facility’s request for capacity increase will be submitted to Licensing Management for the final stage of approval.
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2021
LIC809 (FAS) - (06/04)
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