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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408010
Report Date: 06/06/2019
Date Signed: 06/06/2019 09:49:01 AM

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:
434408010
ADMINISTRATOR:TRABANINO, CATHERINEFACILITY TYPE:
850
ADDRESS:1515 S. DE ANZA BLVDTELEPHONE:
(408) 861-9510
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY:104CENSUS: 75DATE:
06/06/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:59 AM
MET WITH:Catherine TrabaninoTIME COMPLETED:
09:50 AM
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LPA Marilou Monico made a case management inspection to obtain Site Director's signature on the Facility Evaluation Reports (LIC 809s) annual random and case management dated June 5, 2019. Site Director was not able to sign the inspection reports due to computer consistency check issue.

During today's inspection, LPA received paperwork for licensee representative, Jennifer Liu.

A license for 100 preschool children is granted effective today, June 6, 2019.

SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019
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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