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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400331
Report Date: 07/21/2022
Date Signed: 07/21/2022 06:00:05 PM

Document Has Been Signed on 07/21/2022 06:00 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: 55DATE:
07/21/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:16 PM
MET WITH:Marissa MunozTIME COMPLETED:
04:25 PM
NARRATIVE
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management-other inspection. LPA met with Assistant Director Marissa Munoz and explained the reason for the inspection.

During Required -1 year inspection for the infant program, LPA observed around 12:05PM that there were two children in the bathroom between the infant and toddler room. There was no staff present who could visually supervise children in the bathroom. There were two staff in the room, but are unable to see inside of the bathroom from where they were standing. Assistant Director had staff stand by the door. LPA discussed with Assistant Director that children need to be supervised, including visually at all times.

As a result of this inspection, a Type B citation was issued. Exit interview conducted and report was reviewed with Assistant Director Marissa Munoz. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2022
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 07/21/2022 06:00 PM - It Cannot Be Edited


Created By: Samantha Yip On 07/21/2022 at 02:37 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: 07/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/28/2022
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 07/28/2022, Assistant Director stated that she will conduct training with staff about supervision and send proof of staff who attending training to Licensing.
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Based on observation, LPA observed that there were two children in the bathroom. There were no staff standing where they could see the children in the bathroom, wihich poses a potential health and safety risk to children in care.
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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: 07/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2022


LIC809 (FAS) - (06/04)
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