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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413036
Report Date: 06/07/2023
Date Signed: 06/07/2023 12:49:47 PM

Document Has Been Signed on 06/07/2023 12:49 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, 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: 46DATE:
06/07/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Licensee Nikki Yelam and Director Sushma ShresthaTIME COMPLETED:
01:00 PM
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On Wednesday, June 7, 2023 at 9:30 AM, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Case Management Proof of Correction (POC) Visit. LPA met with the Licensee Nikki Yelam and Director Sushma Shrestha and explained the nature of the visit. Present on this visit were 7 staff and 46 preschool children. The facility operates from Monday to Friday 8am to 5:30 pm.

LPA conducted a Case Management Incident visit on May 26, 2023. The incident was reported by the Director on May 24, 2023 at 4 pm.

LPA conducted a facility health and safety inspection and file review.

LPA generated a Letter of Deficiency Citations Cleared on this visit.

No deficiencies cited on this visit.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Licensee Nikki Yelam and Director Sushma Shrestha.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2023
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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