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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274404367
Report Date: 05/02/2024
Date Signed: 05/02/2024 12:00:49 PM

Document Has Been Signed on 05/02/2024 12:00 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:GONZALES UNIFIED SCHOOL DISTRICT STATE PRESCHOOLFACILITY NUMBER:
274404367
ADMINISTRATOR/
DIRECTOR:		NEYFY FERNANDEZFACILITY TYPE:
850
ADDRESS:550-B FIFTH STREETTELEPHONE:
(831) 675-2519
CITY:GONZALESSTATE: CAZIP CODE:
93926
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 11DATE:
05/02/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Erika Valtierra & Eric Olsen TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Elizabeth Larios met with Lead Teacher, Erika Valtierra and Special Education/Health Services/Preschool, Eric Olsen for an unannounced case management inspection. Purpose of today's inspection: inspect the new play structure the facility had installed in the preschool playground, which is located behind portable classroom (B).

Day care children were present during inspection. LPA toured the preschool playground with Eric & Erika during today's inspection.The new play structure is age appropriate (2-5 years of age per placards installed on the play structure) for the preschool children. The play structure is safe, secure, and has rubber padding as resilient materials surrounding and underneath the play structure. Shade is provided by building overhang, and tree. LPA did not observe any bodies of water during today's inspection.

LPA concludes that the facility can start using the play structure for the preschool program effective immediately.

Exit interview conducted and report was reviewed with Lead Teacher Erika Valtierra. No deficiencies issued during today's inspection. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024
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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