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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413426
Report Date: 02/16/2024
Date Signed: 02/16/2024 10:25:24 AM

Document Has Been Signed on 02/16/2024 10:25 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:TULIP KIDS ACADEMYFACILITY NUMBER:
434413426
ADMINISTRATOR:EVANGELINE PONCEFACILITY TYPE:
850
ADDRESS:1159 WILLOW AVENUETELEPHONE:
(408) 340-7993
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 67TOTAL ENROLLED CHILDREN: 60CENSUS: 35DATE:
02/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Evangeline PonceTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Mel Matos met with Evangeline Ponce, director, for an unannounced case management inspection. Purpose of today's inspection: discuss potential use of Activity Room for the Heritage Program. LPA toured the Activity Room with LPA during today's inspection.

Evangeline states that the Facility plans to use the Activity Room for the after school Heritage Program. Evangeline states that the Activity Room is currently used for rainy/hot day activities and special events. Activity Room is not used as classroom space and is not included in the total licensed capacity of the Facility.

LPA notes that the Facility is currently listed on the approved Heritage Program list with the Department of Education. LPA advised Evangeline that the Heritage Program is "exempt" from licensing and thus the Department has no jurisdiction on that program. However, any children enrolled in the Heritage program cannot "commingle" with the licensed programs on site. Facility also has an infant program (#434413427) located on the same premises.

Evangeline states that she understands LPAs explanation and provide any update(s) regarding the start date of the Heritage program.

Exit interview conducted and report was reviewed with Director, Evangeline Ponce. No deficiencies issued during today's inspection. Notice of site visit was issued and must remain posted for 30 days.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2024
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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