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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416578
Report Date: 08/14/2024
Date Signed: 08/14/2024 02:20:59 PM

Document Has Been Signed on 08/14/2024 02:20 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:TULIP KIDS ACADEMYFACILITY NUMBER:
434416578
ADMINISTRATOR/
DIRECTOR:		NIKKI HUFANAFACILITY TYPE:
860
ADDRESS:2280 EL CAMINO REALTELEPHONE:
(669) 377-5774
CITY:SANTA CLARASTATE: CAZIP CODE:
95050
CAPACITY: 78TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/14/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Nikki HufanaTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Licensing Program Analysts (LPAs) Janette Cruz and Jennifer Beehler met with Nikki Hufana, Applicant representative, to conduct an unannounced case management for the purpose of verifying completion of pre-licensing requirements from previous inspection on 08/07/24. LPAs observed an available portable sink within arm’s reach from infant changing table. LPAs also observed that there is a designated infant outdoor space that is fully fenced. An updated fire clearance was received by the Department on 8/9/2024 that approved use of all areas in the building including outdoor infant and preschool play structures.

The following requirement must be completed before licensure will be considered:
1. Approval of waiver for shared outdoor space use for preschool and infant component.

An exit interview was conducted and copy of appeal rights were provided to Nikki Hufana, Applicant. Final license determination for a single license will be made upon review by the Licensing Program Manager.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
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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