430709778-7-1-2021-52-CC-JJAG-C7QPSC-20211012113406

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430709778
Report Date: 07/01/2021
Date Signed: 07/01/2021 12:37:56 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
06/25/2021 and conducted by Evaluator Manel Estoesta

PUBLIC

COMPLAINT CONTROL NUMBER: 52-CC-20210625125453

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	430709778
ADMINISTRATOR:	EVELYN CARRILLO		FACILITY TYPE:	830
ADDRESS:	860 N. HILLVIEW DRIVE		TELEPHONE:	(408) 263-0444
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	27	CENSUS:	DATE:	07/01/2021
		UNANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Lindsay Martin		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility has pests.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On Thursday, July 1, 2021 at 9:37 AM, Licensing Program Analyst (LPA) Manel Estoesta conducted a 10 day complaint initial visit and investigation for the above allegation. LPA met with the Assistant Director Lindsay Martin and explained the nature of the visit. Present on this visit were 14 teachers, 1 cook, 8 infants and 15 toddlers.

LPA toured the facility to conduct a Health and Safety inspection. At 10:10 am, LPA observed a dead cockroach on the bottom cabinet in the Infant Bathroom. At 10:30 am, LPA observed cockroach sticky traps, one behind the kitchen door and one on the pantry floor next to the refrigerators. Both sticky traps are filled with dead coackroaches. At 10:39 am, LPA observed a crawling coackroach on the bottom of the garbage bin in the staff bathrool hallway. At 11 am, LPA interviewed Assistant Director and LPA spoke with Facility Tech Ryan over the phone, both confirmed the evidence of pest (coackroach) in the facility.

SEE 9099 C.

Substantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021

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 3

Control Number 52-CC-20210625125453

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: 430709778
	VISIT DATE: 07/01/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

**********THIS IS AN AMENDED LIC 9099 C. SEE 9099 C DATED 07/01/2021*************

Continuation....

LPA obtained copies of the following;
(1) Children's Roster
(2) Assistant Director's credential information.

Based on the LPA obersavations and staff interviews, the facility is in violation of Title 22, Division 12 Chapter 1 Article 07. Physical Environment 101238 Buildings and Grounds;
(a) The child care 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 A deficiency is cited today as it presents an immediate danger to children.

Upon receipt of this report, licensee shall post this report for 30 days and provide copies of this licensing report to parent/guardians of;

(1) children in care at the facility
(2) children newly enrolled at the facility during the next 12 months.

LIC 9224 Acknowledgement of Receipt of Licensing Reports which is to be placed in each child's file.

Exit interview conducted. A copy of this report was provided. Appeal rights was discussed and a copy was given.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 52-CC-20210625125453

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: 430709778
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/01/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/09/2021 Section Cited CCR 101238(a)(1)	1 2 3 4 5 6 7	********THIS IS AN AMENDED LIC 9099 D. SEE 9099 D DATED 07/01/2021*********** Title 22, Division 12 Chapter 1 Article 07. Physical Environment 101238 Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety......	1 2 3 4 5 6 7	The Assistant Director will submit a written plan of correction with methods and procedures to prevent pest infestation to LPA by 07/09/2021 due date via email or mail.
	8 9 10 11 12 13 14	Based on the LPA obersavations and staff interviews, the condition of the facility indicates that the staff fails to prevent pest infestation. This requirement was not met as evidence. This poses an immediate risk to the Health, Safety and personal rights of the children in care.	8 9 10 11 12 13 14	The Assistant Director shall contract a pest contol company to prepare the facility and to take measures to prevent pest infestation. The Assistant Director shall conduct and document a staff meeting and or training on the facility safe, healthful and comfortable accommodations. The Assistant Director shall forward a copies to LPA.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 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 Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2021

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 3