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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400343
Report Date: 10/03/2019
Date Signed: 10/03/2019 01:32:05 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:
434400343
ADMINISTRATOR:MARISA VALDEZFACILITY TYPE:
830
ADDRESS:400 SOUTH ABELTELEPHONE:
(408) 263-7212
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:36CENSUS: 28DATE:
10/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Marisa ValdezTIME COMPLETED:
01:40 PM
NARRATIVE
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1/ LPA Dayna Collier met with Center Director Marisa Valdez for an annual random inspection. LPA toured the facility and play yard for a health and safety inspection. There were 8 staff members supervising 28 children in care. A review of staff records on 10/3/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Personnel files were reviewed. The teacher/child ratio was being met. Children's files were reviewed. The classroom(s) and play yard were age appropriate. Changing table areas were clean and within reach of water. Bottles, cups and food were labelled. Each child had a daily needs log available for review via the Kindercare App. Infant needs and services plans were being maintained. Meals and snacks for toddlers are either provided by parents or by the facility. Menus were posted. The storage of napping equipment and the arrangement of cribs were appropriate. Blankets are stored in individual cubbies. Staff are aware of the Safe Sleep guidelines. The sign in and out logs were reviewed. All posting requirements are being met. Outdoor play area provided a shaded area for the children and access to drinking water via cups. There was no body of water accessible to children. Medications are not being dispensed at this time but would be stored in the office which is inaccesible to children in care. There is a working telephone. Opening and closing staff have current CPR and first aid training.

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
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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 3
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: 434400343
VISIT DATE: 10/03/2019
NARRATIVE
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The attached type B deficiencies are cited today and must be corrected by the due dates.
An exit interview was conducted and the report was discussed. Licensee 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 DIRECTOR.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: 434400343
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/10/2019
Section Cited

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101216 Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.
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This requirement was not met as evidenced by record review. This poses a potential risk to children in care.
STAFF MEMBERS IDENTIFIED AS S3, S5 AND S8 ARE MISSING HEALTH SCREENING REPORTS IN FILE.
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Type B
10/10/2019
Section Cited

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1596.7995 Employees or volunteers at day care center; immunization requirements; records; exemptions
(a) (1) 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.
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This requirement is not met as evidenced by record review. This poses a potential risk to children in care.
STAFF MEMBERS S1, S5 AND S8 ARE MISSING THE REQUIRED IMMUNIZATIONS IN 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: Diane PerezTELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2019
LIC809 (FAS) - (06/04)
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