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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417104
Report Date: 02/27/2024
Date Signed: 02/29/2024 03:25:13 PM

Document Has Been Signed on 02/29/2024 03:25 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:HUGHES EARLY LEARNING PROGRAMFACILITY NUMBER:
434417104
ADMINISTRATOR:NANCY MORIN-ROMANFACILITY TYPE:
830
ADDRESS:4949 CALLE DE ESCUELA # 27TELEPHONE:
(408) 423-1516
CITY:SANTA CLARASTATE: CAZIP CODE:
95054
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
02/27/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Jennifer Ta/Estrella FlorenceTIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Anna Morales conducted a Case Management visit and was greeted by Site Director Jennifer Ta. LPA observed three infants and one staff.

Site Director informed LPA Morales that she has been the Site Director approximately since 1/2024.
LPA informed Site Director that this was not reported to the Department. LPA informed Site Director that the Department is to be notified within 10 days of a change of child care center director.

Based on the information obtained, a TYPE B citation is being issued at today's visit.
An exit interview was conducted, and Plan of Corrections were reviewed.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 02/27/2024 04:24 PM - It Cannot Be Edited


Created By: Anna Morales On 02/27/2024 at 11:08 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: HUGHES EARLY LEARNING PROGRAM
FACILITY NUMBER: 434417104

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/06/2024
Section Cited
CCR
101212(b)

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101212 Reporting Requirements (b) The... child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).
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LPA Morales received Site Director's packet during the course of this visit. POC is cleared.
Any future Director changes shall be reported to the Department within 10 days.
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Based on interview, the facility did not report change of director to Community Care Licensing (CCL) for review within 10 days of a change of director. This poses a potential risk to the health, safety, and personal rights of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Anna Morales
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2024


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