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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412601
Report Date: 03/09/2023
Date Signed: 03/09/2023 03:45:53 PM


Document Has Been Signed on 03/09/2023 03:45 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
013412601
ADMINISTRATOR:GEMIGNANI-STEARNS, IDAFACILITY TYPE:
850
ADDRESS:38700 PASEO PADRE PARKWAYTELEPHONE:
(510) 796-0888
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:126CENSUS: 91DATE:
03/09/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:09 PM
MET WITH:Ida GemignaniTIME COMPLETED:
03:55 PM
NARRATIVE
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On March 9, 2023 at approximately 1:45pm Licensing Program Analyst (LPA) Haderer arrived unannounced to review an unusual incident where a child was left alone in the classroom during transition time.

LPA visited Classroom 6 to view the spot where the child was left alone and review the transition process. LPA interviewed the site director and the teachers who were present that day.

After the incident, the teachers had their biannual staff training and they covered the importance of name to face and counting during transitioning. Teachers role played and spent time with the site director and district leader reviewing the processes.

LPA issued a Type B deficiency and based on the interviews with staff and the due training that had taken place, LPA was able to clear the deficiency the same day.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the site Director Ida Gemignani

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2023
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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Document Has Been Signed on 03/09/2023 03:45 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 013412601

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/09/2023
Section Cited

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101229 Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time...
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On February 20, 2023 the facility held their biannual training where transitioning, face to name recognition and counting was covered. Site director led the training, joined by the district leader. Role playing was included and a full review was made of the new CSR (Child Supervision Report) form.
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Supervision shall include visual observation.

Based on interview, the licensee did not meet the requirement of supervision by leaving a child alone unattended which poses a potential Health and Safety risk to children in care.
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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.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2023
LIC809 (FAS) - (06/04)
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