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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400331
Report Date: 01/31/2023
Date Signed: 01/31/2023 04:38:11 PM

Document Has Been Signed on 01/31/2023 04:38 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:
434400331
ADMINISTRATOR:MAARIT MCCROSSENFACILITY TYPE:
850
ADDRESS:605 EAST DUNNE AVENUETELEPHONE:
(408) 778-1237
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY: 69TOTAL ENROLLED CHILDREN: 69CENSUS: 64DATE:
01/31/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Maarit McCrossenTIME COMPLETED:
12:01 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Samantha Yip and Marilou Monico conducted an unannounced Case Management- Incident inspection. LPA met with Director Maarit McCrossen and explained the reason for the inspection. The purpose of this inspection is to review a self-reported incident regarding absence of supervision. Facility reported incident to the San Jose Regional Office on 01/25/2023.

During today's inspection, LPA conducted interviews with staff and children. The incident occurred in the Pre-K room. Children were transitioning outside. The door leading outside was closed. C-1 was still inside the classroom. There was a staff who saw the child and brought the child outside.

Director stated that she has done training with her staff regarding supervision and transition. Director will send list of staff who attended training and the agenda.

As a result of this inspection, a Type A citation was issued. A civil penalty of $1000 was assessed for repeating the same violation within a 12 month period. Exit interview conducted and report was reviewed with Director Maarit McCrossen. A notice of site visit has been issued and must remain posted for 30 days.

LPA Samantha Yip informed Director Maarit McCrossen that this report dated 01/31/2023 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Samantha informed the Director, Maarit, to provide a copy of this licensing report dated 01/31/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
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 04:38 PM - It Cannot Be Edited


Created By: Samantha Yip On 01/31/2023 at 03:21 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: 434400331

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/01/2023
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
This requirement is not met as evident by:
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By POC 02/01/2023, Director will conducted training with staff and send the list of staff who received training.
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Based on interview, C-1 was in the classroom by themselves, which poses an immediate risk to children in care.
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Director submitted agenda for training during today's inspection.

A civil penalty of $1000 was assessed.

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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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