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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408010
Report Date: 06/05/2019
Date Signed: 06/06/2019 09:45:54 AM

COMPREHENSIVE INSPECTION
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: 62DATE:
06/05/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH:Catherine TrabaninoTIME COMPLETED:
11:00 AM
NARRATIVE
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Licensing Program Analyst (LPA), Marilou Monico, conducted an annual random inspection. LPA met with Site Director, Catherine Trabanino, and explained the nature of today's visit.

LPA reviewed sign in/sign out sheets and children's roster. Copy of children's roster was obtained. LPA observed all required posted materials: License, Parent’s Rights, Emergency Disaster Plan, menus, Earthquake Preparedness Checklist, Child Passenger Safety Law, and activity schedule.

The facility was toured inside and outside. The facility was observed to be clean, safe, and in good repair. Disinfectants, cleaning solutions, and all other items that are dangerous to children were observed to be securely stored and inaccessible to children. Furniture and equipment were age-appropriate and in good condition. Restrooms for children’s use were observed to be sanitary and operable. Trash cans used for the disposal of solid waste have tight fitting lids. Site Director states that there are no weapons on the premise. LPA observed functioning carbon monoxide and smoke detectors. LPA did not observe any bodies of water. LPA reviewed six random children's files and six staff files. Two teacher's passports were completed.

The facility provides breakfast, snacks and lunch to the children in care. The kitchen was observed to be clean and sanitary. The kitchen is equipped with refrigerators, microwave, stove, oven, dishwasher, and a sink with hot and cold running water.

The preschool program has two yards. The playgrounds are surrounded with appropriate fencing and the outdoor surfaces are safe. Each yard has climbing structures with rubber foam for resilient material. Shade is provided by canopies and trees. Drinking water outdoor is via drinking fountains. LPA observed no bodies of water.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 06/05/19):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434408010
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/05/2019
Section Cited
HSC
1596.8662(b)(1)
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AB1207 Mandated Reporter Training - 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 following the date on which he or she completed the initial mandated reporter training.
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Site Director states she will submit proof of completion for all of her staff by 07/05/19.
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LPA observed that all staff in the preschool program are missing Mandated Reporter Training.
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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: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434408010
VISIT DATE: 06/05/2019
NARRATIVE
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 06/05/19):

Staff present during the inspection have cleared criminal record and child abuse index clearance or exemption. LPA also reminded Site 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: 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 violation within a 12 month period.

LPA discussed Senate Bill 792, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporter Training) which is required training that began on January 1, 2018 and requires renewal every two years. AB 633 was discussed with Site Director. Licensing forms, Title 22 regulations, can be obtained through the internet at ww.ccld.ca.gov. Mandated Reporter Training can be accessed at www.mandatedreporterca.com. LPA discussed and provided Site Director a copy of lead information sheets and advised her to provide copies to parents.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.

Plan of Operation on Incidental Medical Services to be sent to Licensing by July 5, 2019.



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

A NOTICE OF SITE VISIT WAS ISSUE AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019
LIC809 (FAS) - (06/04)
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