434400333-7-3-2024-07-CC-FRAA-D6TMDG-20240703093108

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400333
Report Date: 07/02/2024
Date Signed: 07/03/2024 09:31:14 AM

Document Has Been Signed on 07/03/2024 09:31 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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
ADMINISTRATOR/ DIRECTOR:	LYNDA NGUYEN		FACILITY TYPE:	840
ADDRESS:	3320 SAN FELIPE ROAD		TELEPHONE:	4082700980
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95135
CAPACITY: 50	TOTAL ENROLLED CHILDREN: 50	CENSUS: 30	DATE:	07/02/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:17 PM
MET WITH:	Lynda Nguyen		TIME VISIT/ INSPECTION COMPLETED:	04:45 PM

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	On 07/02/2024 at 2:17pm, Licensing Program Analyst (LPA), Farida Raja, met with Director, Lynda Nguyen, for an unannounced annual/random inspection in the School Age Program. The facility provides before and after school care to children from Kindergarten through 6th grade in one classroom. LPA observed all required posted materials including the daily activity schedule. Infant (#434400332), and preschool age license (#434400334) are on the same premises. Facility offers before school care starting at 6:30am. Days and hours of operation are Monday through Friday, 6:30am - 6:00pm. Director stated that during summer break school age children attend full days. LPA toured the indoor and outdoor areas of the School Age Program during today's inspection. LPA observed 30 children and 3 teachers during today's inspection. Facility was in compliance with teacher to children ratio requirement. There is a working telephone in the facility (408-270-0980). The classroom, children's restrooms, kitchen and office area were inspected. Children were engaged in various activities under supervision of staff. Disinfectants, cleaning solutions or chemicals that are dangerous to the health and safety of children were stored inaccessible to children. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed to be in safe, sanitary, and functioning condition. LPA observed solid waste container with a tight-fitting lids in the room. Director states that there are no weapons or firearms on the premises. LPA observed fire extinguishers, working smoke and carbon monoxide detectors, and fire pull stations. The facility has a built-in smoke detector/ fire system. Log shows that the last Fire Drill was conducted on 02/07/2024 which is compliant with the six-month requirement for facilities. Drinking water is readily available for the children in the classroom and in the outdoor playground area via individual water bottles or water pitcher/disposable cups. Water lead testing was completed by the facility on 10/25/2022 and retested on 3/25/2023. Continued on Page 2

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 07/02/2024

NARRATIVE

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Food storage and preparation areas were observed to be sanitary. The kitchen and storage area is clean and free of litter and rubbish. Foods and beverages were stored safely to prevent contamination and spoilage. All food and beverages that require refrigeration are stored in covered containers. Facility provides breakfast, lunch and PM snack everyday. The menu is in writing and posted for the whole month and is accessible to authorized representatives.

Outdoor playground was inspected and observed to be fenced in and free of hazards. Director stated that school age children take toys outdoors and bring them back inside when they return. LPA observed some outdoor play equipment indoors. There were no bodies of water observed. LPA observed air conditioning condensers barricaded and made inaccessible using a chain link fence.

Children sign in and out procedures and logs were reviewed. Children's Roster was reviewed and a copy was provided to the LPA. LPA reviewed 6 children's files and found them to be current and up to date. LPA reviewed two staff files. All teacher files reviewed contain the required transcripts/verification of experience. At least one staff member on site has a current CPR and First Aid certification on file. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). LPA observed the required Mandated Reporter Training on file for all staff. Through file review LPA observed that staff S1 does not have proof of immunization for pertussis and staff S2 did not have immunization proof for measles and pertussis.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Director is encouraged to visit the Department’s website at www.ccld.ca.gov to access resources for providers, Title 22 Regulations, online option to pay annual license fee, adoption of new laws, etc.

Continued on Page 3

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 07/02/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. Director stated that no children require medication or IMS at this time. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. Any medications at the Facility are stored in each classroom inaccessible to children in care. Isolation of sick child was discussed, and Director explained that sick children will be isolated in the director's office/lobby area and isolation equipment will be provided. A staff restroom which is off limits to other children is used if necessary. Child is always under visual supervision while in care of the facility. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Licensees stated that they transport children. LPA reminded Licensee that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system. Each classroom has a first aid/emergency bag that is taken outdoors during outside play time.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list. childcareadvocatesprogram@dss.ca.gov. Child Care Advocate Program: https://cdss.ca.gov/inforesources/child-care-licensing/child-care-advocates.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Type B deficiency was cited today on the attached LIC 809D pages. Appeal rights were printed and provided to Licensee. LPA reminded Licensee that failure to correct deficiencies by Plan of Correction Due Date may result in civil penalties.Exit interview conducted and report was reviewed with the Director, Lynda Nguyen.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/03/2024 09:31 AM - It Cannot Be Edited

Created By: Farida Raja On 07/02/2024 at 04:04 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: 434400333
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/02/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above for two staff (S1 and S2) which poses a potential health, safety or personal rights risk to persons in care. Through file review LPA observed that staff S1 does not have proof of immunization for pertussis and staff S2 did not have immunization proof for measles and pertussis.
	POC Due Date: 07/16/2024
	Plan of Correction
1 2 3 4	Director will submit proof of missing immunizations for two staff by plan of correction date of 07/16/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Gladys Kuizon

LICENSING EVALUATOR NAME:

Farida Raja

LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024

LIC809 (FAS) - (06/04)

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