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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434400345
Report Date: 01/20/2022
Date Signed: 01/20/2022 12:23:38 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2021 and conducted by Evaluator Manel Estoesta
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20211108164321
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400345
ADMINISTRATOR:FARAHNAZ HASHEMI-TEHRANYFACILITY TYPE:
850
ADDRESS:400 SOUTH ABELTELEPHONE:
(408) 263-7212
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:120CENSUS: 71DATE:
01/20/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Director Farahnaz Hashemi TehranyTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
1. Physical Plant - Facility has pests.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On Thursday, January 20, 2022 10:30 M Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced subsequent complaint investigation. LPA met with the Director Farahnaz Hashemi Tehrany and explained the purpose of the visit. Present on this visit were 71 preschool children and 10 staff.

The finding for the above allegation was delivered during the visit.

During investigation, the department completed a physical plant inspection, reviewed facility records and documentation, and conducted interviews.

1. LPA observed insect sticky traps on 11/16/2021 and 12/21/2021 visits, facility record review showed three (3) Pest Control Maintenance Work Order from September to November 2021 and staff interview confirmed to support the above allegation.
SEE 9099 C...
Substantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 15
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2021 and conducted by Evaluator Manel Estoesta
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20211108164321

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400345
ADMINISTRATOR:FARAHNAZ HASHEMI-TEHRANYFACILITY TYPE:
850
ADDRESS:400 SOUTH ABELTELEPHONE:
(408) 263-7212
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:120CENSUS: 71DATE:
01/20/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Director Farahnaz Hashemi TehranyTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
3. Physical Plant - Facility bathroom is in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On Thursday, January 20, 2022 4:35 AM Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced subsequent complaint investigation. LPA met with the Director Farahnaz Hashemi Tehrany and explained the purpose of the visit. Present on this visit were 71 preschool children and 10 staff.

The finding for the above allegation was delivered during the visit.

During investigation, the department completed a physical plant inspection, reviewed facility records and documentation, and conducted interviews.

3. Facility record review showed a Classroom Restroom Maintenance Work Order from September 2021 and LPA observed a toilet not flushing in Room 3 (three) on 12/21/2021 visit, and staff interview confirmed to support the above allegation.
SEE 9099 C.....
Substantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
VISIT DATE: 01/20/2022
NARRATIVE
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CONTINUATION....

Based on the LPA observation, facility record review and staff interviews, the licensee is in violation of;

Title 22, Division 12 Chapter 1 Article 07. Physical Environment Section 101239 Fixtures, Furniture, Equipment and Supplies

(e) Faucets used by children for personal care shall deliver hot water.

(4) All toilets, handwashing and bathing facilities shall be maintained in safe and sanitary operating condition. Additional equipment, aids and/or conveniences shall be provided as needed in centers that serve children with physical disabilities.

The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The attached type B deficiency is cited today as it presents a potential danger to the children in care.

UUpon receipt of this report, licensee shall post this report for 30 days.

Exit interview conducted with Director Farahnaz Hashemi Tehrany.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 7 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/20/2022
Section Cited
CCR
101239(e)(4)
1
2
3
4
5
6
7
101239 Fixtures, Furniture, Equipment and Supplies (e) Faucets used by children for personal care shall deliver hot water. (4) All toilets, handwashing and bathing facilities shall be maintained in safe and sanitary operating condition.........
1
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The Director submitted a Completed Maintenance - Bathroom receipt dated 01/07/2022.
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Based on LPA's obervation, record review and staff interview that the licensee did not maintain all toilet in safe and sanitary operating condition which poses a potential Health and Safety risk to persons in care.
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9
10
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14
The Director stated that she will incorporate Identifying Hazards in the facility on their monthly meeting. Faclity's next staff meeting is on 02/21/2022.
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7
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7
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: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 8 of 15
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2021 and conducted by Evaluator Manel Estoesta
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20211108164321

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400345
ADMINISTRATOR:FARAHNAZ HASHEMI-TEHRANYFACILITY TYPE:
850
ADDRESS:400 SOUTH ABELTELEPHONE:
(408) 263-7212
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:120CENSUS: 71DATE:
01/20/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Director Farahnaz Hashemi TehranyTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
2. Physical Plant - Facility playground is in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On Thursday, January 20, 2022 4:35 AM Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced subsequent complaint investigation. LPA met with the Director Farahnaz Hashemi Tehrany and explained the purpose of the visit. Present on this visit were 71 preschool children and 10 staff.

The finding for the above allegation was delivered during the visit.

During investigation, the department completed a physical plant inspection, reviewed facility records and documentation, and conducted interviews.

2. LPA observed the facility play area had an uneven pavement on 11/16/2021 and 12/21/2021 visits. Facility record review showed two (2) Playground Pavement Maintenance Work Order from September to November 2021, and staff interview confirmed to support the above allegation.
SEE 9099 C.
Substantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
VISIT DATE: 01/20/2022
NARRATIVE
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7
8
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CONTINUATION...

Based on the LPA observation, facility record review and staff interviews, the licensee is in violation of;

Title 22, Division 12 Chapter 1 Article 07. Physical Environment 101238.2 Section Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained:
(2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The attached type B deficiency is cited today as it presents a potential danger to the children in care.

Upon receipt of this report, licensee shall post this report for 30 days.

Exit interview conducted with Director Farahnaz Hashemi Tehrany.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/20/2022
Section Cited
CCR
101238.2(d)(2)
1
2
3
4
5
6
7
101238.2 Section Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained:
(2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard......
1
2
3
4
5
6
7
The Director submitted a Completed Maintenance - Cement/pavement receipt dated 01/14/2022.
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Based on LPA's obervation, record review and staff interview that the licensee did not maintain the outdoor activity space free of hazards which poses a potential Health and Safety risk to persons in care.
8
9
10
11
12
13
14
The Director stated that she will incorporate Identifying Hazards in the facility on their monthly meeting. Faclity's next staff meeting is on 02/21/2022.
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6
7
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: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
VISIT DATE: 01/20/2022
NARRATIVE
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CONTINUATION....

Based on the LPA observation, facility record review and staff interviews, the licensee is in violation of;
Title 22, Division 12 Chapter 1 Article 07. Physical Environment Section 101238 Buildings and Grounds;
(a) The childcare center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. (1) The licensee shall take measures to keep the center free of flies, other insects, and rodents......

The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The attached type B deficiency is cited today as it presents a potential danger to the children in care.

Upon receipt of this report, licensee shall post this report for 30 days.

Exit interview conducted with Director Farahnaz Hashemi Tehrany.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 15
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2021 and conducted by Evaluator Manel Estoesta
COMPLAINT CONTROL NUMBER: 52-CC-20211108164321

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400345
ADMINISTRATOR:FARAHNAZ HASHEMI-TEHRANYFACILITY TYPE:
850
ADDRESS:400 SOUTH ABELTELEPHONE:
(408) 263-7212
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:120CENSUS: 71DATE:
01/20/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Director Farahnaz Hashemi TehranyTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
4. Physical Plant - Facility floors are in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On Thursday, January 20, 2022 4:35 AM Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced subsequent complaint investigation. LPA met with the Director Farahnaz Hashemi Tehrany and explained the purpose of the visit. Present on this visit were 71 preschool children and 10 staff.

The finding for the above allegation was delivered during the visit.

During investigation, the department completed a physical plant inspection, reviewed facility records and documentation, and conducted interviews.

4. LPA observed loose tiles in classroom 2-3 on 12/21/2021 visit. Facility record review showed 2-3 Classroom Flooring Maintenance Work Order from September to November 2021, and staff interview confirmed to support the above allegation.
SEE 9099 C.....
Substantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 9 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
VISIT DATE: 01/20/2022
NARRATIVE
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CONTINUATION....

Based on the LPA observation, facility record review and staff interviews, the licensee is in violation of;

Title 22, Division 12 Chapter 1 Article 07. Physical Environment Section 101238.3
Indoor Activity Space

(b) The floors of all rooms shall have a surface that is safe and clean.

The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The attached type B deficiency is cited today as it presents a potential danger to the children in care.

Upon receipt of this report, licensee shall post this report for 30 days.

Exit interview conducted with Director Farahnaz Hashemi Tehrany.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 10 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/20/2022
Section Cited
CCR
101238.3(b)
1
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3
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5
6
7
101238.3 Indoor Activity Space
(b) The floors of all rooms shall have a surface that is safe and clean....
1
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3
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7
The Director submitted a Completed Maintenance - Room Tiles receipt dated 01/06/2022.
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14
Based on LPA's obervation, record review and staff interview that the licensee did not maintain the floors of all rooms shall have a surface that is safe and clean which poses a potential Health and Safety risk to persons in care.
8
9
10
11
12
13
14
The Director stated that she will incorporate Identifying Hazards in the facility on their monthly meeting. Faclity's next staff meeting is on 02/21/2022.
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7
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: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 11 of 15
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2021 and conducted by Evaluator Manel Estoesta
COMPLAINT CONTROL NUMBER: 52-CC-20211108164321

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400345
ADMINISTRATOR:FARAHNAZ HASHEMI-TEHRANYFACILITY TYPE:
850
ADDRESS:400 SOUTH ABELTELEPHONE:
(408) 263-7212
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:120CENSUS: 71DATE:
01/20/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Director Farahnaz Hashemi TehranyTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
5. Physical Plant - Facility windows are in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On Thursday, January 20, 2022 4:35 AM Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced subsequent complaint investigation. LPA met with the Director Farahnaz Hashemi Tehrany and explained the purpose of the visit. Present on this visit were 71 preschool children and 10 staff.

The finding for the above allegation was delivered during the visit.

During investigation, the department completed a physical plant inspection, reviewed facility records and documentation, and conducted interviews.

5. LPA observed the windows on Room 3 to 7 stuck shut and would not open on 12/21/2021 visit. Facility record review showed a Classroom Window Maintenance Work Order on November 2021 to support the above allegation.
SEE 9099 C.....
Substantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 12 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
VISIT DATE: 01/20/2022
NARRATIVE
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CONTINUATION.....

Based on the LPA observation, facility record review and staff interviews, the licensee is in violation of;

Title 22, Division 12 Chapter 1 Article 07. Physical Environment Section 101239 Fixtures, Furniture, Equipment and Supplies

(b) All window screens shall be in good repair and free of insects, dirt and debris.



The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The attached type B deficiency is cited today as it presents a potential danger to the children in care.

Upon receipt of this report, licensee shall post this report for 30 days.

Exit interview conducted with Director Farahnaz Hashemi Tehrany.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 13 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/20/2022
Section Cited
CCR
101239(b)
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101239 Fixtures, Furniture, Equipment and Supplies
(b) All window screens shall be in good repair and free of insects, dirt and debris.....
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The Director submitted a Completed Maintenance - Windows receipt dated 01/14/2022.
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Based on LPA's obervation, record review and staff interview that the licensee did not maintain all window screen in good repair and free of insects, dirt and debris which poses a potential Health and Safety risk to persons in care.
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The Director stated that she will incorporate Identifying Hazards in the facility on their monthly meeting. Faclity's next staff meeting is on 02/21/2022.
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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: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 14 of 15
Control Number 52-CC-20211108164321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 434400345
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/20/2022
Section Cited
CCR
101238(a)(1)
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101238 Buildings and Grounds;
(a) The childcare center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. (1) The licensee shall take measures to keep the center free of flies, other insects, and rodents......
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The Director submitted a Completed Maintenance - Pest Control receipt dated 12/21/21.
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Based on LPA's obervation, record review and staff interview that pest such as cockroaches was evident in the facility which poses a potential Health and Safety risk to persons in care.
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The Director stated that there is an ogoing monthly pest control schedule, LPA was provided a copy of the schedule.
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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: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC9099 (FAS) - (06/04)
Page: 15 of 15