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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709779
Report Date: 12/13/2019
Date Signed: 12/13/2019 03:03:56 PM

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:
430709779
ADMINISTRATOR:MONICA VILLALOBOSFACILITY TYPE:
850
ADDRESS:860 N. HILLVIEW DRIVETELEPHONE:
(408) 263-0444
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:87CENSUS: 32DATE:
12/13/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Lindsay MartinTIME COMPLETED:
03:30 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
12/13/2019 Licensing Program Analysts (LPA’s), Leslie Ibo & Jason Jang, conducted an unannounced random inspection to the facility today. LPA’s met with center assistant director Lindsay Martin explained the nature of today's visit. LPA Leslie Ibo met with director Evelyn Carillo at 2:15PM. LPA’S toured the facility both inside and outside during today's visit. LPA’s 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.

At 2:20PM a review of staff records on indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances.

LPA’s reviewed children and staff files during today's visit. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). The staff files reviewed contains the required transcripts/verification of experience. The new immunization requirement (pertussis, measles, and flu vaccines) for all Licensees and staff, volunteers that work directly with the children was present is the files. Director has CPR and First Aid certifications on file with expiration date of 1/8/2021. 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 off-site activities (field trips).
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Leslie IboTELEPHONE: (510) 622-2646
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
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 2
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: 430709779
VISIT DATE: 12/13/2019
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
LPA’s observed that the teacher/child ratio are in compliance during today's visit. Director understands the conditions, limitations, and capacity specifications of the facility license. Director understands that children shall always be visually supervised.

LPA’s observed that all rooms are clean and safe for all children and staff. LPA’s observed solid waste containers with tight-fitting lids throughout the facility. Children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed.



The food preparation and storage areas are clean. All food and beverages that require refrigeration are stored in covered containers. Cleaning supplies are stored on high shelves away from children. Any medications at the facility are stored in the office. LPA's observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. Drinking water is readily available for the children inside the facility and in the outdoor playground.
LPA's observed that the outdoor equipment is age appropriate and in good condition. There are sufficient resilient materials in the outdoor playground area. LPA’s did not observe any bodies of water.
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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
No deficiencies cited Today
A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Leslie IboTELEPHONE: (510) 622-2646
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2