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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417020
Report Date: 02/17/2022
Date Signed: 02/18/2022 11:04:16 AM

Document Has Been Signed on 02/18/2022 11:04 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:AGAPE PLAYSKOOLFACILITY NUMBER:
434417020
ADMINISTRATOR:ADLIN SOFIA NETTOFACILITY TYPE:
850
ADDRESS:181 EAST TASMAN DRIVE #70TELEPHONE:
(669) 295-8697
CITY:SAN JOSESTATE: CAZIP CODE:
95134
CAPACITY: 45TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/17/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Adlin NettoTIME COMPLETED:
11:40 AM
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Licensing Program Analysts (LPAs) Mel Matos and Dung Mac conducted an announced follow up Pre-licensing inspection to the facility today. LPAs met with the Applicant/Site Director, Adlin Netto. The initial pre-licensing inspection was completed on January 18, 2022. The Facility is applying for a preschool license for 45 preschool children in Rooms 1, 2, and 3.

The Applicant/Site Director was advised during the initial inspection of the following items that needed to be completed prior to a follow-up inspection.
1) Kitchen needs to be fully setup.
2) Hot water in children's sinks.

LPAs inspected the indoor areas of the Facility, including the kitchen, with the Applicant during today's inspection. The following items were observed during today's inspection.
1) Two ceiling panels in Room 1 have water stains and need to be replaced.
2) Kitchen area needs to be clean and fully operational, including sufficient food inventory.
3) The toilet tank in one of children's bathrooms is cracked/not stable and needs to be replaced.
4) Sufficient tables, chairs, cubbies, and materials for 45 children (requested capacity) need to be present in the Facility.
5) Staff bathroom and classrooms need to be labeled.
6) Daily schedules reflecting staggered usage of indoor activity area need to be submitted.
7) Entire Facility flooring and walls need to cleaned and free of dust/debris.
8) Wall thermostat is not functional.
9) Plastic film covering on ceiling lights needs to be removed.
10) Children's sinks have hot water (less than 120 degrees F).

LPAs conducted an exit interview with Adlin Netto, Applicant representative/Site Director, and she agreed to submit the pictures of the completed/corrected items (#1-#10) listed above to LPA Mac by February 22, 2022. A follow up inspection will be required once items #1-#10 have been completed.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2022
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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