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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417085
Report Date: 07/18/2023
Date Signed: 07/18/2023 02:22:29 PM

Document Has Been Signed on 07/18/2023 02:22 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:AGAPE PLAYSKOOLFACILITY NUMBER:
434417085
ADMINISTRATOR:ADLIN SOFIA NETTOFACILITY TYPE:
850
ADDRESS:3700 THOMAS ROAD, SUITE 107TELEPHONE:
(669) 295-8697
CITY:SANTA CLARASTATE: CAZIP CODE:
95054
CAPACITY: 24TOTAL ENROLLED CHILDREN: 10CENSUS: 1DATE:
07/18/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Adlin Sofia NettoTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Mel Matos met with Adlin Sofia Netto, Licensee representative/Director, for an unannounced case management inspection. LPA observed one preschool child with Adlin in the Facility during today's inspection.

Adlin states that she has ten children enrolled; however, the majority of the enrolled children are only part time.

Adlin states that she might be selling her day care business in the near future. Adlin states that she is unsure when/if she might be selling the business. LPA advised Adlin to notify the Department in writing if she elects to sell and close her business.

Exit interview conducted and report was reviewed with the Licensee representative/Director, Adlin Netto. No deficiencies issued during today's inspection.

A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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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