Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413597
Report Date: 09/15/2016
Date Signed 09/15/2016 11:37:53 AM

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:HEARTS AND HANDS CHRISTIAN CHILDCARE AND PRESCHOOLFACILITY NUMBER:
434413597
ADMINISTRATOR:STACY E. SILVEYFACILITY TYPE:
850
ADDRESS:400 LLEWELLYN AVENUETELEPHONE:
(408) 412-8823
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY:70CENSUS: 40DATE:
09/15/2016
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Stacy SilveyTIME COMPLETED:
11:05 AM
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Unannounced plan of correction visit made by Analyst Jean Walton. Met with Director Stacy Silvey.

Checked deficiencies previously cited:

BUILDINGS AND GROUNDS - New pads for the changing tables were purchased. The tops of the diaper genies have been covered with a material that can be wiped clean.

TEACHER QUALIFICATIONS AND DUTIES -Staff have copies of their official transcripts in their files.

The above deficiencies have been corrected.

NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Jean WaltonTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2016
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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