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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400069
Report Date: 11/29/2022
Date Signed: 11/29/2022 03:45:53 PM

Document Has Been Signed on 11/29/2022 03:45 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:SCHOLARS ACADEMYFACILITY NUMBER:
434400069
ADMINISTRATOR:ARSHIA ALIFACILITY TYPE:
850
ADDRESS:3703 SILVER CREEK ROADTELEPHONE:
(408) 238-2500
CITY:SAN JOSESTATE: CAZIP CODE:
95121
CAPACITY: 167TOTAL ENROLLED CHILDREN: 167CENSUS: 37DATE:
11/29/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Ali, ArshiaTIME COMPLETED:
04:15 PM
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On this day Licensing Program Analyst (LPA) Almaraz, Celi conducted an unannounced case management visit. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. There were a total of 37 children in care at the initial start of the visit, which took place during pick up and 4 staff present. Teacher child ratios observed, staff names recorded, personal rights observed. LPA/s met with Director Ali, Ashria to discuss the purpose of this visit, which is to observe an off limits play area that a waiver has been requested for use. The Director would like to use a side play yard for children to ride tricycles and have other outdoor activities, such as painting in this area.

LPA was taken on a guided tour of the area and observed the following: The off limits area is a gated area behind the outdoor playground. This area is on the right side of the inside of the playground. The area is shaded and has sufficient space to provide outdoor drinking water and keep emergency backpacks when children are in area. There is a storage shed that has a washer and dryer inside, this has a lock. There is a gate behind the storage shed, which has pipes for washer/dryer, that also has a lock, LPA has recommended to place an additional latch. The gated area is adjacent to the play ground, separated by another gated area. LPA observed there are three exits: 1. Leads to a gated back area of play ground. 2. Goes back to the play ground. 3. Goes to the front lawn of the school. This area (Front lawn) is mostly out of view of the staff. LPA has obtained photos and discussed this with Licensing Program Manager (LPM) Stephenson, Diana a request must be re-submitted once a fire inspection has been done. The purpose of the fire inspection will be to assess the area and the safety exit plan, in the event of an emergency. Upon approval of use of the area of the fire department, the Community Care Licensing Department (CCLD) must obtain record of approval prior to considering a waiver request. Once a request for a waiver is re-submitted to CCLD, the request will be reviewed and require manager approval. Director understands that LPA may need to conduct another visit. There were no deficiencies issued during inspection.

NOTICE OF SITE VISIT ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS. 1/1
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2022
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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