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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400342
Report Date: 07/26/2023
Date Signed: 07/27/2023 12:48:14 PM


Document Has Been Signed on 07/27/2023 12:48 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400342
ADMINISTRATOR:LORA ALMONDFACILITY TYPE:
850
ADDRESS:840 BING DRIVETELEPHONE:
(408) 246-2141
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY:108CENSUS: 37DATE:
07/26/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Marcella TarinTIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Anna Morales conducted an Case Management visit in response to an unusual incident that was self-reported by the facility to Licensing on June 8,2023. LPA met with Director Marcella Tarin. LPA toured the facility, interviewed staff, reviewed files, and obtained documents.

Based on available evidence and interviews, it was determined that on June 7, 2023, the children in Toddler Classroom 3 were playing outside in the playground when staff S1 realized that C1 (Child)was standing in the Infant Playground close to the open/unlocked gate that separates the two playgrounds (Infants and Toddlers). S1 stated that she was alone and supervising a total of 12 children outside in the playground approximately at 4:00pm. Interview was conducted with C1's parent (P1) who stated that upon entering the toddler playground upon pick up, P1 asked where C1 was and that is when S1 and P1 observed C1 standing by the unlocked gate to the Infant play ground. Director and S1 stated that the gates to all of the gates in the playgrounds are to be kept locked at all times.

As a result of this inspection, deficiency was cited on the following page:

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:
DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/26/2023
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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Document Has Been Signed on 07/27/2023 12:48 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400342

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/27/2023
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision(a)(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Program Director stated that she will submit a plan to ensure that children are supervised and the gates to playgrounds remain locked at times by the POC date. This is a zero-tolerance violation, an immediate civil penalty of $500 was assessed during the inspection
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This requirement was not met as evidenced by: A child was left unattended inside the Infant Playground on June 7,2023. The gate to that separates the infant and toddler playground was left unlocked. This is a zero tolerance violation. This poses an immediate risk to the health, safety, and personal rights to children in care.
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Upon receipt, Director shall post and provide copies of this licensing report, have LIC 9224 signed and kept on file, to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. According to AB 633, parents must be provided with this report which contains this Type A deficiency for the next 12 months & copy of the signed acknowledgment form must be kept in each child's file.

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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: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:
DATE: 07/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/26/2023
LIC809 (FAS) - (06/04)
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