<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
434416196
Report Date:
09/08/2022
Date Signed:
09/27/2022 02:25:19 PM
Document Has Been Signed on
09/27/2022 02:25 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-DAY CARE
,
2580 N FIRST STREET, STE. 300
SAN JOSE
,
CA
95131
FACILITY NAME:
COMMUNITY FIRST SCHOOL
FACILITY NUMBER:
434416196
ADMINISTRATOR:
LE, DIEU-MI
FACILITY TYPE:
850
ADDRESS:
1098 WEST REMINGTON DRIVE
TELEPHONE:
(408) 739-2022
CITY:
SUNNYVALE
STATE:
CA
ZIP CODE:
94087
CAPACITY:
144
TOTAL ENROLLED CHILDREN:
144
CENSUS:
14
DATE:
09/08/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
09:27 AM
MET WITH:
TIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
SUPERVISORS NAME
:
Diana Stephenson
LICENSING EVALUATOR NAME
:
Harsimran Kaur
LICENSING EVALUATOR SIGNATURE
:
DATE:
09/08/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
09/08/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
1