<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412603
Report Date: 10/07/2022
Date Signed: 10/07/2022 06:10:02 PM


Document Has Been Signed on 10/07/2022 06:10 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:
013412603
ADMINISTRATOR:GEMIGNANI-STEARNS, IDAFACILITY TYPE:
830
ADDRESS:38700 PASEO PADRE PARKWAYTELEPHONE:
(510) 796-0888
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:32CENSUS: 19DATE:
10/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Azra ArshadTIME COMPLETED:
06:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On October 7, 2022 at approximately 8:30am, LPA Haderer arrived unannounced for an annual inspection for compliance to Health and Safety. The new CARE tool was used for the inspection. Present for the inspection was the assistant site director Azra Arshad, 6 teachers and 19 infant children in care. The center location has a preschool and an infant center license. The physical inspections were done simultaneously.

The infant center is located in Rooms 1 (children up to 12 months) and Room 2 (12 to 24 months). All 0-12 month infants in care had the Individual Infant Safe Sleeping Plan form LIC9224 signed by each parent and present in the classroom. Infant Sleep logs were available to track and monitor sleeping infants.



The children have their own playground yard, all is in safe condition and free from sharp, loose or pointed parts. There are bubble mirrors installed to assist teachers to see the full playground area. Access to drinking water is available and teachers are always present.

Disaster drills are conducted at least once every six months, the last drill was conducted 9/29/2022. The facility has 3A10BC fire extinguishers in the classrooms, the last inspection was done 2/17/2022. There was one fire extinguisher in Room 2 was not fully charged. See LIC809D for deficiency. Fremont Fire Department conducts fire inspections, the last inspection was completed 12/19/2019, independent alarm inspections were done by Century Fire Protection 11/10/2021 and SSD Alarm 7/29/2021. Carbon monoxide and smoke detectors were available for the adjoining classrooms 1 and 2. Heating and ventilation in the classrooms are acceptable.

Changing tables are available in each classroom (within arm’s length of the sink). There are enough towels and soap supplies. The staff have separate adult bathroom located in the school office.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5


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: 013412603
VISIT DATE: 10/07/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The facility is clean and well organized with ample age appropriate furnishings and equipment. Surfaces including floors and counter tops are clean and toxic free. Hazardous items/toxins are kept in staff storerooms out of the access of children. There are no bodies of water accessible to children in care. The facility provides snacks and lunch (including formula and milk) for the children, menus were appropriately posted.

The sign in/out sheets were reviewed and were not accurate. One child in Room 1 was not signed in by his parent. See LIC809D for deficiency. Classrooms have trash cans with tight fitting cover for the disposal of solid waste. There is a child that requires IMS (EpiPens). Medications are located in the classroom out of the reach of children and proper paperwork and IMS plan was available. It was found that the EpiPen was expired, see LIC809D for deficiency.

Children's records were reviewed, all records were complete and in good order. All LIC9227 Infant Safe Sleeping Plans were completed and signed by parents, safe sleep logs are maintained and found to be complete.

Staff files were reviewed. Opening and closing staff have current CPR and first aid training. All staff subjected to criminal review have been cleared and associated to the facility.

All documents required to be posted were appropriately posted on the walls: License; Emergency Disaster Plan; Earthquake Preparedness checklist; Notification of Parents Rights; Personal rights; Child seatbelt laws; menus; daily activity schedules.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) 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/childqanda.htm
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: 013412603
VISIT DATE: 10/07/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Assistant site director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with assistant site director 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 assistant site director 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.

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 inspectionprocess@dss.ca.gov. 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/inspection-process.

There were 3 deficiencies issued today, see LIC809D for details.

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



Exit interview conducted and report was reviewed with Assistant Site Director Azra Arshad.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 10/07/2022 06:10 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: 013412603

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(a)(1)
Sign In and Sign Out
(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in that one parent did not sign their child in which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/10/2022
Plan of Correction
1
2
3
4
Licensee to send out a communication to all parents on the importance of signing in and out their children everyday and if not if is not adhered to, it poses a risk to their child and to the childcare center.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4

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: 10/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 10/07/2022 06:10 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: 013412603

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101223(a)(2)

(a) The licensee shall ensure that each child is accorded the following personal rights:

(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement is not met as evidenced by:
An expired EpiPen was found during the inspection.
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that there was an expired EpiPen which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
1
2
3
4
The expired EpiPen was removed and will be returned to the parents. A new EpiPen will be collected from the parents and keep in case there is a need. Going forward, licensee will maintain a constant check of expiration dates for all medications.
Type B
Section Cited
CCR
101238(a)
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:

A fire extinguisher was not fully charged.
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that in Room 2 there was a fire extinguisher that was not fully charged (needle was in the re-charge red area) which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2022
Plan of Correction
1
2
3
4
Licensee will have the fire extinguisher serviced and checked that it is in safe operating condition and can maintain a full charge.

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: 10/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5