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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413426
Report Date: 05/15/2024
Date Signed: 05/15/2024 02:48:05 PM

Document Has Been Signed on 05/15/2024 02:48 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:TULIP KIDS ACADEMYFACILITY NUMBER:
434413426
ADMINISTRATOR/
DIRECTOR:		EVANGELINE PONCEFACILITY TYPE:
850
ADDRESS:1159 WILLOW AVENUETELEPHONE:
(408) 340-7993
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 67TOTAL ENROLLED CHILDREN: 61CENSUS: 54DATE:
05/15/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Evangeline PonceTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Mel Matos met with Evangeline Ponce, Director, for an unannounced case management inspection. LPA toured the indoor areas of the Facility with Evangeline Ponce, Director, during today's inspection.

LPA observed 23 napping preschool children with one partially qualified teacher in the Jr Preschool (Room 1), 12 napping preschool children in the Pre-K (Room 2) with one fully qualified teacher, and 19 napping children with two fully qualified teachers in the Preschool (Room 3).

LPA notes that the Facility uses mats and cots for napping children. LPA observed that the mats and cots were in good condition.

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: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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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