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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202124
Report Date: 02/26/2025
Date Signed: 02/26/2025 11:50:17 AM

Document Has Been Signed on 02/26/2025 11:50 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:BEYOND POTENTIAL LEARNING CENTERFACILITY NUMBER:
435202124
ADMINISTRATOR/
DIRECTOR:		CARMELA MAGPAYOFACILITY TYPE:
775
ADDRESS:1753 SOUTH MAIN STREETTELEPHONE:
(408) 438-0442
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 75CENSUS: 62DATE:
02/26/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Melissa Ramos Program DirectorTIME VISIT/
INSPECTION COMPLETED:
12:05 PM
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Licensing Program Analysts (LPA) Marcela Yanez and Licensing Program Manager April Cowan conducted an unannounced visit and met with Administrator (ADM) Melissa Ramos LPA announced the purpose of the visit. LPAs observed 62 Clients and 31 Staff.

LPA toured the facility inside and out with ADM which included the main activity area and music room, kitchen, dining room, restrooms. The staff area of the facility was also inspected. The outside of the facility was also inspected. There was no obstruction to block the walkways. LPA observed 12 Vans that take Clients to community outings and to and from home. ADM stated vans are serviced for scheduled maintenance and as needed.

During the visit, LPAs observed clients doing marching around the room to music in the main activity area. During tour LPAs observed cubby holes where the Clients place their personal items.

LPAs observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 70 degrees F, and hot water temperature was measured with thermometer 118-119 degrees F in both the men's and women's restroom. LPAs observed paper towels and soap and covered trash cans.

There were 3 fire extinguishers observed in the facility and were last serviced in 08/30/24 LPAs observed a dual fire alarm system with carbon monoxide detectors which in all areas. ADM stated that the dual alarm system is maintained every year and last time it was serviced was on 09/2024. LPAs observed facility first aid kit.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: BEYOND POTENTIAL LEARNING CENTER
FACILITY NUMBER: 435202124
VISIT DATE: 02/26/2025
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LPAs reviewed the facility fire/earthquake drill log. The facility's last disaster drill was conducted on 01/13/25.
LPA reviewed facility records for 3 staff and 3 residents. LPA interviewed 3 staff and attempeted 2 clients non verbal and 1 client that was verbal

No deficiencies cited during today's visit. This report was reviewed with Administrator Melissa Ramos and a copy of the signed report was provided.
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025
LIC809 (FAS) - (06/04)
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