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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709779
Report Date: 03/03/2020
Date Signed: 03/03/2020 04:37:06 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:EVELYN CARRILLOFACILITY TYPE:
850
ADDRESS:860 N. HILLVIEW DRIVETELEPHONE:
(408) 263-0444
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:87CENSUS: 61DATE:
03/03/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:LINDSAY MARTINTIME COMPLETED:
03:00 PM
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On 0303/2020, Licensing Program Analyst (LPA) Manel Estoesta met with Assistant Director Lindsay Martin for a Case Management Inspection as a result of receiving an unusual incident report. During the inspection, there were 8 staff members supervising 61 preschool children in care.

An incident reported to the facility on 02/26/2020 at 08:00 AM by P1. LPA Estoesta received the incident report on 02/27/2020 via fax. P1 claims that C1 had a physical interaction for behavior redirection by S3 that lead to a scratch on C1 finger. C1 was not present on today's visit. As per assistant director's internal investigation, no substantial mark on C1 finger that caused by physical interaction, staff underwent another training again on positive redirection and positive reinforcement and C1 was moved to a PRE Kindergarten Class effective 02/28/2020 as per P1 request. LPA interviewed staff and reviewed children's file including the facility's completed Incident/Accident Report for Parent/Guardian. LPA observed that staff always look for ways to positively reinforce to an inappropriate behavior.

Documents obtained are Children's Roster, a blank copy of an Incident/Accident Report for a Parent /Guardian, Facility's Behavior Guidelines, and Positive Behavior Training Manual.

There are no deficiencies cited on today's visit.

An exit interview was conducted and the report was discussed. Assistant Director was provided a copy of their appeal rights (LIC 9058 12/15) and the signature on this form acknowledges receipt of these rights.



A SITE VISIT NOTICE WAS POSTED BY THE ASSISTANT DIRECTOR.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020
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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