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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444414061
Report Date: 10/01/2026
Date Signed: 10/01/2026 12:50:58 PM

Document Has Been Signed on 10/01/2026 12:50 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:FAMILY NETWORK PRESCHOOLFACILITY NUMBER:
444414061
ADMINISTRATOR/
DIRECTOR:		WILEY, MELISSAFACILITY TYPE:
850
ADDRESS:1225 Brommer STTELEPHONE:
(831) 462-2535
CITY:Santa CruzSTATE: CAZIP CODE:
95062
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 13DATE:
10/01/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:02 AM
MET WITH:Victoria NoblesTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On 10/01/2026 Licensing Program Analyst (LPAs), Jaime Gonzales and Jessmin Villanueva conducted an unannounced Annual Random Inspection visit. LPAs were greeted by Site Director, Melissa Wiley and Co-Licensee, Victoria Nobles. LPAs explained the reason for todays visit. The facility operates Monday - Thursday from 8:30 AM to 3:30 PM. The preschool program serves children ages 2 years to 5 years old. The facility has an active waiver to allow ill children to use one of the two toilet/hand washing fixtures currently in place to meet overall ratio. The waiver is posted and conditions are followed.

LPAs toured the indoor and outdoor areas of the facility. LPAs observed four staff present with 13 children. LPAs observed four rabbits in the closed barn space, and two dogs. The classrooms have age-appropriate materials, toys, furnishing, equipment, & adequate storage for children’s belongings. The children's napping equipment were observed to be stored in a healthful manner. Bedding is provided by the center and is washed weekly or as needed. LPAs observed fully charged 3A40BC fire extinguisher, functioning smoke and carbon monoxide detectors. The isolation area for sick children is in the office.

The center provides snacks to children and the snack was posted in the facility. Parents provide lunch to the children. All center provided food items are properly labeled & stored separately from cleaning supplies. Snacks are prepared in the kitchen. Trash cans for the disposable of solid wastes are equipped with tight fitting lids. Drinking water is available for children in the classrooms via individual water bottles and are refilled throughout the day by a filtered pitcher by staff.

The outdoor play areas are fully fenced. Shade is provided by trees. All equipment and surfaces are free from hazards. There are no bodies of water on the premises. There are age-appropriate outdoor toys and materials for the children. Per Site Director, there are no firearms or weapons on the premises.

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Adam Hamer
Jaime Gonzales
DATE: 10/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2026
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: FAMILY NETWORK PRESCHOOL
FACILITY NUMBER: 444414061
VISIT DATE: 10/01/2026
NARRATIVE
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LPAs reviewed 8 random children files during today's inspection for the following records: Admission Agreement, Personal Rights (LIC 613A), Identification and Emergency Information (LIC 700), Notification of Parents Rights (LIC 995A), Consent for Emergency Medical Treatment (LIC 627), Physician’s Report with TB test (LIC 701), and Immunization Records.

LPAs reviewed four staff files for the following records: Health Screening Report (LIC 503), TB Test, Statement Acknowledging Requirement to Report Child Abuse (LIC 9108), Employee rights (LIC 9052), staff qualifications, immunization records, and required training. One staff (S3) had expired Mandated Reporter Training and did not have active background check clearance with the Department of Social Services. Based on interview with Victoria Nobles, S3 has been working at the facility since 2025 and was present at the facility today.

LPAs Jaime Gonzales and Jessmin Villanueva informed Co-Licensee, Victoria Nobles that this report dated 10/01/2026 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.



Also, LPAs Jaime Gonzales and Jessmin Villanueva informed the Co-Licensee, Victoria Nobles to provide a copy of this licensing report dated 10/01/2026 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Co-Licensee, Victoria Nobles was reminded of their responsibility to renew CPR/First Aid and Mandated Reporter Training every two years.

Co-Licensee, Victoria Nobles was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Continued on Page 3...

NAME OF LICENSING PROGRAM MANAGER: Adam Hamer
NAME OF LICENSING PROGRAM ANALYST: Jaime Gonzales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2026
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: FAMILY NETWORK PRESCHOOL
FACILITY NUMBER: 444414061
VISIT DATE: 10/01/2026
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN-22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/resources/child-care-centers/.


LPAs reminded Co-Licensee, Victoria Nobles to report unusual incidents or injuries to children in care to the Department of Social Services using the Unusual Incident/Injury Report form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624, within 7 calendar days.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

Continued on Page 3...For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).


LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Co-Licensee, Victoria was informed of the MyChildCarePlan.org website; 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

As a result of this inspection, there were one Type A and two Type B deficiencies were cited during todays inspection.

A Notice of Site Visit was given and must remain posted for 30 days. Report was reviewed with the Co-Licensee, Victoria Nobles.

NAME OF LICENSING PROGRAM MANAGER: Adam Hamer
NAME OF LICENSING PROGRAM ANALYST: Jaime Gonzales
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/01/2026 12:50 PM - It Cannot Be Edited


Created By: Jaime Gonzales On 10/01/2026 at 11:57 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: FAMILY NETWORK PRESCHOOL
FACILITY NUMBER: 444414061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/01/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview with Co-Licensee, Victoria Nobles the licensee did not comply with the section cited above as S3 who has been working at the facility since 2025 and was present at the facility today did not have active background check clearance with the Department of Social Services which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/02/2026
Plan of Correction
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Co-Licensee, Victoria Nobles will send S3 home and will have her complete live scan today and will not have S3 return to work at the facility until there is an active Background Check Clearance with the Department of Social Services. Co-Licensee will submit a copy of the fingerprint clearance live scan form to the department by 10/02/2026 and submit a plan of action of how they will prevent this in the future.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Adam Hamer
NAME OF LICENSING PROGRAM MANAGER:
Jaime Gonzales
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/01/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/01/2026 12:50 PM - It Cannot Be Edited


Created By: Jaime Gonzales On 10/01/2026 at 11:57 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: FAMILY NETWORK PRESCHOOL
FACILITY NUMBER: 444414061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/01/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as S3 was missing current valid mandated reporter training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/08/2026
Plan of Correction
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Licensee will provide a plan to the department of when staff will complete the training and how they will remember when it is due in the future by POC due date 10/08/2026.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as S3 was missing the immunization record for measles in the file, which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/08/2026
Plan of Correction
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Licensee will submit a copy of the immunization record and a plan to the department of how they will collect the records from staff by POC due date 10/08/2026.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Adam Hamer
NAME OF LICENSING PROGRAM MANAGER:
Jaime Gonzales
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/01/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2026


LIC809 (FAS) - (06/04)
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