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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400340
Report Date: 08/09/2019
Date Signed: 08/09/2019 01:54:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400340
ADMINISTRATOR:GINA SWANNFACILITY TYPE:
830
ADDRESS:840 BING DRIVETELEPHONE:
(408) 246-2141
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY:56CENSUS: 30DATE:
08/09/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Lauren FerrellTIME COMPLETED:
02:10 PM
NARRATIVE
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Licensing Program Analyst (LPA), Shannel Reed, Assistant Director, Lauren Ferrell for an unannounced annual/random inspection in the Infant Program. The Facility is currently licensed in Infant Rooms 1, 2, and 7. LPA observed 30 children with 9 teachers and Aides. LPA 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.
LPA toured the indoor and outdoor areas of the Facility during today's inspection. LPA observed that all rooms are clean and safe for all children and staff. The Assistant Director states that the facility has a company custodian that cleans the facility Monday through Friday in the evenings. Drinking water is readily available for the children in each room via water fountains, personal sippy cups or bottles. The classrooms are clean and safe for all children and have sufficient and age appropriate toys and material for the children in care. LPA observed solid waste containers with tight-fitting lids in each room. Children's bathrooms and changing table areas 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 Assistant Director states that there are no weapons or firearms on the premises.
The facility provides AM/ PM snacks and Lunch from the onsite kitchen. LPA observed in the onsite kitchen, storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children. Any medications at the Facility are stored in the kitchen and are inaccessible to children in care. The facility conducts monthly fire and emergency disaster drills. The last fire drill was conducted in June 2019.
LPA observed that the facility has sufficient napping equipment, and the Assistant Director understands that a teacher or aide is required to be present in the nap room any time a child is placed in the room.
LPA observed all furniture and equipment is in good condition and safe for the children. The playground areas utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children.
REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 08/09/2019):
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel ReedTELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400340
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/09/2019
Section Cited
HSC
1596.7995
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Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This
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The Director shall submit proof of immunity of Measles, Pertussis and Influenza (or an opt out statement for Influenza) for all staff who provide care and supervision to children in care, to CCL by the POC due date of September 09, 2019.
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requirement is not met as evidenced by: LPA observed that at least 8 of the facility staff do not have proof of Immunity against influenza, pertussis, and measles on file. This poses a potential health and safety risk to children in care.
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Type B
09/24/2019
Section Cited
HSC
1596.8662(b)
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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years.
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The Director shall ensure that she and all facility staff complete the Mandated Reporter training (AB1207) and shall submit a copy of the certificate of completion to CCL by the POC due date of September 24, 2019.
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This requirement is not met as evidenced by: LPA observed that the facility most of the staff have not completed the required Mandated Reporter training (AB1207) as of August 09, 2019. This is a potential risk to the children in care and a deficiency to the Health and Safety regulations.
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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: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel ReedTELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400340
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/12/2019
Section Cited
CCR
101170(e)(3)
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Criminal Record Clearance: All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request and be approved for a transfer of a criminal record exemption, as specified in Section 101170.1(r), unless, upon request for a
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The Assistant Director faxed the information to CCL at the time of the inspection. LPA confirmed that the Staff member has been associated and is cleared to work at the facility today. The facility Director shall provide a written statement to CCL indicating what steps the facility will implement to ensure that the facility is operating within
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transfer, the Department permits the individual to be employed, reside or be present at the facility.
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the required criminal background clearance for all staff members by the POC due date of Monday, August 12, 2019.

Per AB633 Parent Notification is required.
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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: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel ReedTELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400340
VISIT DATE: 08/09/2019
NARRATIVE
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 08/09/2019):
LPA observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient material on the outdoor playground areas. Shade is provided by large tree and building overhang. LPA did not observe any bodies of water. LPA reviewed six (6) children’s files and observed all of the required documents and the Feeding and Needs and Services plans are updated quarterly or as needed.
LPA reviewed nine (9) staff files during today's inspection. A review of staff records indicates that all individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. However, teaching staff member, Elianne Perez, has not been associated to the facility as per the Criminal Record Clearance requirement. LPA reminded the Assistant Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month period. Therefore, a Civil Penalty has been assessed.
All teacher files reviewed contain the required transcripts/verification of experience. At least one staff member onsite has a current CPR and First Aid certification on file. The 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 off-site activities (field trips). The Assistant Director understands the conditions, limitations, and capacity specifications of the Facility license. The Assistant Director understands that children shall be visually supervised at all times.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the Assistant Director of their responsibility to stay current in regard to new regulations. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list childcareadvocatesprogram@dss.ca.gov. The Mandated Reporter Training (AB1207) can be completed at the website listed. http://www.mandatedreporterca.com. LPA discussed Assembly Bill (AB) 2370 and gave Lead Safety information.
LPA obtained a Facility roster and conducted an exit review with the Assistant Director.
Title 22 Deficiencies were observed and cited on the attached pages of this report.
LPA discussed the requirements of AB 633 with the Licensee and provided the copy of the Acknowledgement of Receipt of Licensing Report (LIC 9224)
NOTICE OF SITE VISIT WAS GIVEN AND MUST BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel ReedTELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4