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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413036
Report Date: 07/20/2023
Date Signed: 08/03/2023 01:27:35 PM

Document Has Been Signed on 08/03/2023 01:27 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: 0DATE:
07/20/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Licensee - Nikki YelamTIME COMPLETED:
01:45 PM
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On Thursday, July 20, 2023 at 1:15 pm, Regional Manager Anika Evans, Licensing Program Manager (LPM) Jason Jang, Licensing Program Analysts (LPAs) Manel Estoesta and Jaleesa Jackson met with the Licensee Nikki Yelam and Facility's Managing Director Hem Korubilli for a Non Compliance Conference (NCC) at Oakland South East Regional Office.

The NCC discussion included the Case Management - Incident dated 05/26/2023, Complaint Report dated 06/07/2023, the Deficiency, the Civil Penalty, Plan of Correction (POC) and Regional Office recommendation to maintain the facility's in compliance.

LPA Estoesta reviewed and provided a copy of the report to the Licensee.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2023
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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