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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414557
Report Date: 01/05/2024
Date Signed: 01/18/2024 02:42:37 PM

Document Has Been Signed on 01/18/2024 02:42 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:LA SALLE EDUCATION CENTERFACILITY NUMBER:
434414557
ADMINISTRATOR:NGUYEN, BICHVAN THIFACILITY TYPE:
850
ADDRESS:248 KIRK AVENUETELEPHONE:
(408) 480-2770
CITY:SAN JOSESTATE: CAZIP CODE:
95127
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 25DATE:
01/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Bichvan NguyenTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Sheena Chin conducted an unannounced Case Management inspection at the facility today and met with the director, Bichvan Nguyen. The purpose of today’s inspection is to review the amended 12/7/2023 report with the director and follow up on the plan of correction. The director has sent LPA copies of the required documents, mandated reporter training certificate and water lead test results via email by due date.

LPA toured the facility. Present were 4 staff and 25 children in care during the inspection.



Deficiency
No deficiency was observed today.

Exit interview was conducted, and the report was reviewed and discussed with director, Bichvan Nguyen.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 01/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/05/2024
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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