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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417262
Report Date: 05/14/2025
Date Signed: 05/14/2025 01:50:23 PM

Document Has Been Signed on 05/14/2025 01:50 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:ALLSTARS STEM PRESCHOOLFACILITY NUMBER:
434417262
ADMINISTRATOR/
DIRECTOR:		MADAN BELLAMFACILITY TYPE:
860
ADDRESS:2650 ABORN ROADTELEPHONE:
(408) 406-3728
CITY:SAN JOSESTATE: CAZIP CODE:
95121
CAPACITY: 30TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
05/14/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Maden BellamTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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On 05/14/2025 Licensing Program Analyst (LPA) Janette Cruz met with Madan Bellam Applicant representative. The purpose of the visit was an announced pre-licensing inspection at the facility to ensure the health, safety and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. There are no children present during this inspection. This is an application for a preschool license with capacity of 18 children ages 2-6 years in Rooms R1/R2/R3 and R4 and 12 toddlers (18 – 36 months) in toddler room R5. The child care center will operate Monday–Friday 8:00AM - 6:00 PM. The fire clearance was approved on April 22, 2025. Per facility fire clearance, facility has approval in the following areas R6 is kitchen, B1/B2 are bathrooms and play area 1 & 2 are the big yard and small yard. The facility is located at the main building education wing of a church site, Grace Church of Evergreen. The Applicant operates a school age after school licensed under Heritage Program (250130080618753-J5S2) from Monday to Fridays, 2pm - 6:30pm at the church Grace Hall and annex room separate from the preschool classrooms.

LPA toured and measured the on-limits areas and classrooms located at the facility. The facility has a total of 3 classrooms.
Preschool Classroom measurements are:
The Indoor total measurements contain a total of {654.95} square feet, which will accommodate Applicant’s request for 18 preschool children.

Toddler Classroom measurements are:
The Indoor total measurements contain a total of {511.39} square feet, which will accommodate Applicant’s request for 12 toddler children.

Preschool Outdoor Play measurements are:
Outdoor total measurements contain a total of {12,699.68} square feet, which will accommodate Applicant’s request for 18 preschool children.
Applicant stated that a waiver will be submitted to share the play area 2 (big yard) between preschool and toddler children which measures 9577.11 square feet.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Janette Cruz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: ALLSTARS STEM PRESCHOOL
FACILITY NUMBER: 434417262
VISIT DATE: 05/14/2025
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Toddler Outdoor Play measurements are:
Outdoor total measurements contain a total of {1398.96} square feet, which will accommodate Applicant’s request for 12 toddler children.

All indoor and outdoor activity space utilized for the children were inspected today. LPA informed Applicant that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. LPA observed all classrooms to be clean, safe, sanitary and in good repair. A comfortable temperature for children shall be maintained at all times. Applicant were advised that temperature in rooms that children occupy between a minimum of 68 degrees F and a maximum of 85 degrees F. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children, including toys, shall be free of toxic substances. All play equipment and materials used by children were observed to be age-appropriate. There are 37 chairs, 5 tables, 32 cubbies 30 cots, 2 toilets and 3 sinks available for preschool and toddler children. Staff have one separate bathroom that can be utilized by sick children if needed. Sick children will be isolated in Room 5 area of the facility. Applicant was advised that the isolation area shall be equipped with a a cot or mat for each ill child. First aid supplies, medication, and cleaning products are stored and kept inaccessible to children. The Applicant shall take measures to keep the center free of flies, other insects, and rodents. Applicant was advised that all containers used for storage of solid wastes, including moveable bins, shall have a tight fitting cover that is kept on. LPA observed no open face heaters or fireplace. LPA observed fully charged fire extinguisher and smoke detectors at the facility.

Applicant was reminded that a child who is between 18 months and 36 months of age may participate in the toddler program with written permission from the child's authorized representative. No child in the toddler program shall be placed in the preschool program before the age of 30 months without written permission from the child's authorized representative.

LPA observed the facility has fully fenced outdoor playgrounds with separate areas for toddlers and preschool children. The fence is at least four feet high. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. Any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care. The areas around and under high climbing equipment, swings, slides and other similar equipment was observed to be cushioned with grass that can absorb a fall. Applicant understands that no child(ren) shall be left without visual supervision of a teacher at any time. Outdoor shade was provided by trees and canopies. LPA observed no bodies of water. Applicant stated that there are no weapons stored in the facility premises.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Janette Cruz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: ALLSTARS STEM PRESCHOOL
FACILITY NUMBER: 434417262
VISIT DATE: 05/14/2025
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Facility shall provide lunch and snacks for the children. The facility has food preparation area with refrigerator, microwave and hot/cold running water. Kitchen area is kept clean and free of litter and rubbish. Drinking water is readily available for the children in the facility via water bottles, water pitchers and water fountains.
Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPA advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.
Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed Applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed with the Applicant LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Janette Cruz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: ALLSTARS STEM PRESCHOOL
FACILITY NUMBER: 434417262
VISIT DATE: 05/14/2025
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following corrections are needed before licensure will be considered.

1. proof of repair on plugged up sink in room 4
2. proof of age sticker for preschool playground climbing structure
3. proof of available carbon monoxide detector
4. Updated facility sketch using LIC999 form
5. sensor alarm and barrier set-up at the exit door in toddler room R5 to ensure children safety
6. shared playground waiver for toddler and preschool to use the big yard 2 (open field). Mention of Heritage program use by school age children from 2pm - 6:30pm
7. proof of separation/fencing between toddler yard and preschool yard - small children yard 1
8. proof of maintenance on lawn, fixed tarpaulin and repainted outdoor play equipment located in small children yard 1
9. signed letter from landlord that there is no church activity during facility operation hours that can disrupt toddler designated space Room 5. In addition, letter from landlord specifying rooms designated for Heritage program.
10. plan for shared bathrooms and sinks use between toddlers and preschool children (applicant will purchase potty chairs available for toddlers who need potty training.
11. Final review of application packet.

An exit interview was conducted and copy of appeal rights and this report was provided to the Applicant Representative: Madan Bellam. Final license determination will be made upon review by the Licensing Program Manager and correction of the above issues.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Janette Cruz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC809 (FAS) - (06/04)
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