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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416995
Report Date: 12/08/2022
Date Signed: 12/08/2022 03:05:05 PM

Document Has Been Signed on 12/08/2022 03:05 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:VIDYARAMBH CUPERTINOFACILITY NUMBER:
434416995
ADMINISTRATOR:SUJATHA NAMBOODIRIFACILITY TYPE:
850
ADDRESS:10041 NORTH BLANEY AVENUETELEPHONE:
(408) 444-5019
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY: 47TOTAL ENROLLED CHILDREN: 13CENSUS: 10DATE:
12/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:22 PM
MET WITH:Sujatha NamboodiriTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Marilou Monico met with Site Director, Sujatha Namboodiri, for a Case Management Inspection in response to Licensee's request to check the newly installed cushioning material under the climbing structure in Yard III.

LPA toured Yard III. LPA observed rubber foam as resilient material by the slide landing area and by the stairs of the climbing structure. LPA observed synthetic grass under and around the climbing structure. The cemented walkway of the playground was replaced with rubberized material.

There were no deficiencies cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2022
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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