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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413036
Report Date: 12/05/2022
Date Signed: 12/05/2022 11:43:19 AM

Document Has Been Signed on 12/05/2022 11:43 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:GLOBAL VILLAGE MONTESSORIFACILITY NUMBER:
434413036
ADMINISTRATOR:SELVASUMATHI NAMOKAREANFACILITY TYPE:
850
ADDRESS:1146 JACKLIN ROADTELEPHONE:
(408) 956-8711
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: DATE:
12/05/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Sushma ShresthaTIME COMPLETED:
12:00 PM
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On Monday, December 5, 2022 at 10:04 AM, Licensing Program Analyst (LPA) Manel Estoesta conducted a Case Management Visit - Proof of Correction (POC). LPA met with the Director Sushma Shrestha and explained the nature of the site visit. Present on this visit were 8 staff and 39 preschool children.

The facility has a deficiency on 11/16/2022 Required 1 Year Inspection, see LIC D 11/16/2022. LPA generated a POC Clearance Letter and gave a copy to the Director. LPA Estoesta received an email from the Director on 12/1/2022 regarding her course enrollment with Administration, and EMSA Prevention, Health and Safety. LPA discussed to the Director that the Licensee need to send an Exception Request to the Department for the Director's qualification until the Director complete all the missing requirement. The Director understood.

No deficiencies cited on this visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Sushma Shrestha.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2022
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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