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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408813
Report Date: 11/21/2024
Date Signed: 11/26/2024 09:14:49 AM

Document Has Been Signed on 11/26/2024 09:14 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:BRIGHT HORIZONS AT LOS GATOSFACILITY NUMBER:
434408813
ADMINISTRATOR/
DIRECTOR:		ANDREW TRYFOROSFACILITY TYPE:
830
ADDRESS:220 BELGATOS ROADTELEPHONE:
(408) 356-7989
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 21DATE:
11/21/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Lauren GuerreroTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jennifer "Jen" Beehler conducted an unannounced inspection for the purpose of investigating a self reported incident. LPA met with Acting Director (AD) Lauren Guerrero and was provided access to the facility.

LPA interviewed staff, collected documentation and relevant evidence. LPA reviewed child’s file and it was complete. The facility provided an unusual incident report (UIR) on 11/11/2024 to the licensing department for an incident that occurred on 11/08/2024. LPA investigated an incident of a child sustaining an injury requiring medical attention.

LPA did not find any evidence to indicate the child sustained the injury due to lack of supervision; therefore, no citation was issued as a result of this investigation.

Continued on Page 2 on the attached LIC-809C



***Amended document signed by Kellie Venell in the absence of Director during return visit on 11/26/2024.

Continued on Page 2
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: BRIGHT HORIZONS AT LOS GATOS
FACILITY NUMBER: 434408813
VISIT DATE: 11/21/2024
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During today's inspection LPA observed the Director listed on the facility file was the past Director. LPA reminded AD that licensing needs to approve and change the Director's of facilities. LPA reviewed the LIC308 and LIC200A with AD and answered questions. AD provided a packet for LPA to review and will submit an updated LIC200A to the department reflecting any updates for the facility including the Director.

Due to today's inspection, no deficiency was cited. Exit interview conducted with Acting Director Lauren Guerrero, report reviewed and provided. NOTICE OF SITE VISIT WAS PROVIDED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC809 (FAS) - (06/04)
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