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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440710237
Report Date: 05/16/2024
Date Signed: 05/16/2024 10:50:34 AM

Document Has Been Signed on 05/16/2024 10:50 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:DE LA VEAGA CKC INC.FACILITY NUMBER:
440710237
ADMINISTRATOR/
DIRECTOR:		MILLETE, JAHMARFACILITY TYPE:
840
ADDRESS:1145 MORRISSEY BOULEVARDTELEPHONE:
(831) 461-5229
CITY:SANTA CRUZSTATE: CAZIP CODE:
95065
CAPACITY: 200TOTAL ENROLLED CHILDREN: 200CENSUS: 0DATE:
05/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Kylie RobertsTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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Licensing Program Analysts (LPAs) Harsimran Kaur and Janette Cruz conducted an unannounced Case Management site visit in response to facility's notification to add a classroom and change of capacity. LPAs met with Kylie Roberts, Executive Director. De La Veaga CKC Inc. is currently a licensed School Age Program with a capacity of 200 children operating on a functioning elementary school site, DeLaveaga Elementary School. This School Age Program is licensed to operate in portable classrooms: 42, 34, 35 and the multipurpose room. However, facility had informed Licensing Office intent to add Room 6A-Little Theater as an additional licensed space and requested capacity increase for a total of 250 school-age children.

A fire clearance has been granted for 6A-Little Theater on 3/19/24. Facility has submitted a letter from the Elementary School Superintendent stating that maximum capacity approved for the 6A-Little Theater is 185 children.

LPAs inspected 6A-Little Theater. 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. 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, pursuant to Health and Safety Code Section 1596.806.

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 De La Veaga CKC Inc. to operate in 6A-Little Theater upon review by the Licensing Program Manager.

An exit interview was conducted and a copy of appeal rights and this report was provided to the Kylie Roberts, Executive Director.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2024
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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