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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430700197
Report Date: 11/07/2023
Date Signed: 11/09/2023 02:12:44 PM


Document Has Been Signed on 11/09/2023 02:12 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:KIDDIE KAMPUS DAY CARE CENTERFACILITY NUMBER:
430700197
ADMINISTRATOR:SUSAN COREYFACILITY TYPE:
850
ADDRESS:16330 LOS GATOS BOULEVARDTELEPHONE:
(408) 356-6776
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:171CENSUS: 129DATE:
11/07/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kellie Knepper and Susie CoreyTIME COMPLETED:
03:30 PM
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Licensing Program Analysts (LPAs) Jessica Bongardt and Anna Morales met with Kellie Knepper, Assistant Director and Susie Corey Director, for an unannounced Required - 1 Year inspection. LPA toured the indoor and outdoor areas of the Facility with Kellie during today's inspection. LPAs observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. Days and hours of operation are Monday through Friday 8:00AM to 5:00PM.

LPAs reviewed ten children's and seven staff files during today's inspection. Each child's file reviewed contains all required forms/documents, including Admission Agreement, Emergency Medical Consent (LIC 627), and Information and Emergency Information form (LIC 700). All staff files reviewed contain the required forms/documents, including current CPR and First Aid certifications on file. There were five out of the seven staff files reviewed that did not have current Mandated Reporter Training on File. Assistant Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during any off-site activities. Last fire/disaster drill was completed on 09/29/2023.

LPAs observed that the teacher/child ratio was in compliance during today's inspection. LPAs observed 23 Staff and 129 Children during today's inspection. Kellie understands the conditions, limitations, and capacity specifications of the Facility license. She understands that children shall be visually supervised at all times. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted into care. Any child(ren) who become ill during the day, shall be isolated in the Assistant director’s or Directors office area.

LPAs observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Kellie states that the Facility has Janitorial Cleaning service they come Monday through Thursday and on Saturday Night. Kellie understands that the Facility must be kept free of flies and other insects & rodents. LPAs observed that furniture and equipment is in good condition and safe for the children. Children have their own water bottles labeled with their name on it, when playing outdoors there are water cooler stations for the children along with they have their water bottles.

SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Jessica BongardtTELEPHONE: 408-834-2558
LICENSING EVALUATOR SIGNATURE:
DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/07/2023
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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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: KIDDIE KAMPUS DAY CARE CENTER
FACILITY NUMBER: 430700197
VISIT DATE: 11/07/2023
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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

LPAs provided Director/Assistant Director with website resources on managing food allergies at school and handling medical emergencies related to food allergies.

CDC Managing Food Allergies at School

https://www.cdc.gov/healthyschools/foodallergies/index.htm

American Academy of Pediatrics Healthy Children Medical Emergencies

https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/When-to-Call-Emergency-Medical-Services-EMS.aspx

Exit interview conducted and report was reviewed with Susie, Director and Kellie, Assistant Director. No Deficiencies were issued at this time.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Jessica BongardtTELEPHONE: 408-834-2558
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023
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: KIDDIE KAMPUS DAY CARE CENTER
FACILITY NUMBER: 430700197
VISIT DATE: 11/07/2023
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LPAs observed there is hot and cold running water, refrigerator and microwave on the premises. Lunch and AM/PM snacks are provided from the facility. The Facility has trash cans with tight fitting lids for solid waste in the classroom. Cleaning supplies are inaccessible to the children and stored in cabinets located in areas off limits to children. LPAs observed a complete first aid kit available in the facility.

The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPAs observed that the outdoor equipment is age appropriate and in good condition. Shade rest areas are provided by trees. There is sufficient resilient materials on the outdoor playground area. LPAs did not observe any bodies of water. Director/Assistant Director states that the Facility does not provide transportation for preschool children.

Director/Assistant 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.

This facility does provide Incidental Medical Services (IMS) at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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)/ (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

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.
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).

Director/Assistant Director understands that children's personal rights should not be violated; including no unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Jessica BongardtTELEPHONE: 408-834-2558
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023
LIC809 (FAS) - (06/04)
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