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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400329
Report Date: 01/31/2023
Date Signed: 01/31/2023 04:42:52 PM

Document Has Been Signed on 01/31/2023 04:42 PM - It Cannot Be Edited

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:
434400329
ADMINISTRATOR:MAARIT MCCROSSENFACILITY TYPE:
830
ADDRESS:605 EAST DUNNE AVENUETELEPHONE:
(408) 778-1237
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 30DATE:
01/31/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:01 PM
MET WITH:Maarit McCrossenTIME COMPLETED:
03:00 PM
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Licensing Program Analysts (LPAs) Samantha Yip and Marilou Monico conducted an unannounced Case Management- Lead Testing/Exceedance inspection. LPAs met with Director Maarit McCrossen and explained the reason for the inspection. The purpose of this inspection is facility had a result of over 5ppb on two of their water faucets; sink in the kitchen and water fountain in the infant/toddler yard/playground. The sink in the kitchen had a result of 15 ppb and the water fountain in the infant/toddler yard/playground had a result of 42ppb.

During today's inspection, LPAs inspected the sink in the kitchen and water fountain outside in the yard. Facility removed the water fountain outside and boxed it. Facility uses individual water bottles and water filter. Facility has a sign on the kitchen sink and is doing flushes four times a day. There is another sink to prepare meals and snacks. Facility will be retesting the water. Facility will send test results once they obtain it to Licensing.

As a result of this inspection, a type B citation was issued. Exit interview conducted and report was reviewed with Director Maarit McCrossen. A notice site visit has been issued and must remain posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2023
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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Document Has Been Signed on 01/31/2023 04:42 PM - It Cannot Be Edited


Created By: Samantha Yip On 01/31/2023 at 03:32 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400329

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2023
Section Cited

101700.3(b)(1)

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Lead Testing Written Directives. A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement is not met as evident by:
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By POC 03/01/2023, facility has replaced the part in the sink and has been doing 30 second flushes. Facility will retest the water. There is another sink to prepare meals and snacks.
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The kitchen sink had a result of 15 ppb and the water fountain in the infant/toddler yard/playground had a result of 42 ppb, which poses a potential health and safety risk to children in care.
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Facility has removed the water fountain in the infant/toddler yard/playground and covered it.

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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:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2023


LIC809 (FAS) - (06/04)
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