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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417300
Report Date: 05/23/2024
Date Signed: 05/23/2024 01:30:57 PM

Document Has Been Signed on 05/23/2024 01:30 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:BELLGRAD EVERGREEN STEM ACADEMYFACILITY NUMBER:
434417300
ADMINISTRATOR/
DIRECTOR:		EMERALD PEOPLEFACILITY TYPE:
840
ADDRESS:3010 FOWLER ROAD, CLASSROOM 31TELEPHONE:
(408) 568-3674
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY: 35TOTAL ENROLLED CHILDREN: 34CENSUS: 21DATE:
05/23/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Swetha NadamuniTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analysts (LPAs) Janette Cruz and Farida Raja conducted an unannounced Case Management site visit in response to facility's notification to add a classroom and change of capacity. LPAs met with Swetha Nadamuni, Applicant/Chief Executive Officer. Bellgrad Evergreen Stem Academy is currently a licensed School Age Program with a capacity of 35 children operating on a functioning elementary school site, Evergreen Elementary School. This School Age Program is licensed to operate in portable classroom 31. However, facility had informed Licensing Office intent to add classroom 30 as an additional licensed space and requested capacity increase for a total of 70 school-age children.

A fire clearance has been granted for classrooms 30 & 31 on 05/15/24. Facility has submitted a letter from the Elementary School Principal stating that maximum capacity approved for classrooms 30 & 31 is 70 children.

LPAs inspected indoor and outdoor areas. LPAs observed that items that may pose a danger to children were stored inaccessible to children. There were furniture, such as tables and chairs available for children. During this inspection, classrooms 30 and 31 were measured with total of 1520.09 square feet. Since this School Age Program operates on a functioning school site, pursuant to Health and Safety Code Section 1596.806 the Program is exempt from requirements for square-footage of indoor and outdoor activity space, toilet, fencing, and isolation space for child day care centers.

Based on today's inspection, LPAs determined that the facility's physical plant is in compliance with applicable Health & Safety Codes and Title 22 Regulations. A school age license shall be issued for Bellgrad Evergreen Stem Academy to operate upon review by the Licensing Program Manager.

An exit interview was conducted and a copy of appeal rights and this report was provided to Swetha Nadamuni, Applicant/Chief Executive Officer. Notice of site visit was given and must be posted for 30 days.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2024
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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