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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434400333
Report Date: 08/29/2024
Date Signed: 08/29/2024 04:39:45 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/05/2024 and conducted by Evaluator Farida Raja
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240705120744
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400333
ADMINISTRATOR:LYNDA NGUYENFACILITY TYPE:
840
ADDRESS:3320 SAN FELIPE ROADTELEPHONE:
(408) 270-0980
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY:50CENSUS: 31DATE:
08/29/2024
UNANNOUNCEDTIME BEGAN:
01:12 PM
MET WITH:Lynda NguyenTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Staff handled day care child in a rough manner resulting in injuries
INVESTIGATION FINDINGS:
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On 08/29/2024 at 1:12pm, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced complaint visit to deliver findings for the above allegation. LPA met with Director, Lynda Nguyen and explained the purpose of today's visit.

During today's inspection, LPA toured the facility and observed ratios. During the course of this investigation, LPA interviewed director, staff and children and reviewed relevant records. LPA reviewed photographs obtained and video footage of the incident.

Based on staff and children interviews, they stated that child, C1 was trying to run away from staff as C1 did not want to leave the bowling alley. Staff, including staff (S1), tried to hold and calm C1 as C1 was kicking and attempting to run away. 4 witnesses who were interviewed stated staff held C1 down. 1 stated staff was grabbing C1 by the arm.

Continued on Page 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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 7
Control Number 07-CC-20240705120744
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400333
VISIT DATE: 08/29/2024
NARRATIVE
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Based on photographs obtained of child, C1, marks are visible on the upper right arm from this incident.

Based on interviews conducted and evidence gathered during the investigation process, the Department found that the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. One Type B deficiency was cited today on the attached LIC 9099 D.

Exit interview conducted with Director, Lynda Nguyen. Appeal rights provided.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 07-CC-20240705120744
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400333
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/06/2024
Section Cited
CCR
101223(a)(3)
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101223 Personal Rights (a) (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement is met as evidenced by:
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Director shall develop a plan of correction and train staff to ensure that all children are handled appropriately so as not to violate their Personal Rights. Director shall conduct a training for staff regarding appropriate handling of children and submit a plan of correction by due date of 09/06/2024.
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Based on staff and children interviews, 4 witnesses who were interviewed stated staff held C1 down. 1 stated staff was grabbing C1 by the arm. Based on photographs obtained of child, C1, marks are visible on the upper right arm from this incident. This poses a potential risk to the health, safety and personal rights of 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.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/05/2024 and conducted by Evaluator Farida Raja
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240705120744

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400333
ADMINISTRATOR:LYNDA NGUYENFACILITY TYPE:
840
ADDRESS:3320 SAN FELIPE ROADTELEPHONE:
(408) 270-0980
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY:45CENSUS: 31DATE:
08/29/2024
UNANNOUNCEDTIME BEGAN:
01:12 PM
MET WITH:Lynda NguyenTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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2
3
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9
Staff threatened day care child
INVESTIGATION FINDINGS:
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On 08/29/2024 at 1:12pm, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced complaint visit to deliver findings for the above allegation. LPA met with Director, Lynda Nguyen and explained the purpose of today's visit.

During today's inspection, LPA toured the facility and observed ratios. During the course of this investigation, LPA interviewed director, staff and children and reviewed relevant records.

Based on interviews by staff and children, they stated that at the end of the bowling session child, C1 was upset when asked to take bowling shoes off to get ready to leave. No staff were observed threatening C1.

Continued on Page 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 07-CC-20240705120744
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400333
VISIT DATE: 08/29/2024
NARRATIVE
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Based on interviews conducted and evidence gathered during the investigation process, it is concluded that although the allegation listed above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is thus UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with Director, Lynda Nguyen.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 7