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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400342
Report Date: 08/15/2023
Date Signed: 08/15/2023 04:37:09 PM

Document Has Been Signed on 08/15/2023 04:37 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400342
ADMINISTRATOR:LORA ALMONDFACILITY TYPE:
850
ADDRESS:840 BING DRIVETELEPHONE:
(408) 246-2141
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY: 108TOTAL ENROLLED CHILDREN: 108CENSUS: 30DATE:
08/15/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Marcella TarinTIME COMPLETED:
01:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Anna Morales conducted an Case Management visit in response to an unusual incident that was self reported by the facility to Licensing on 8/3/2023. LPA met with Director Marcella Tarin. LPA toured the facility, interviewed staff, reviewed files, and obtained documents.

Based on available evidence and interviews, it was determined that on August 3, 2023, that S1 went to pick up the Preschool ( classroom numbers 4/5) students from the Homeroom(Classroom One) to take them the Preschool. During the transition, C1 was left without supervision in the front Lobby. S2 arrived at approximately at 8:30am, and observed C1 standing without supervision by the printer. S2 stated that she/he took C1 back to the Preschool. According to the Child Supervision Record, there were eight(8) Preschool students present.

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 Marcella Tarin. A notice of site visit has been issued and must remain posted for 30 days. Appeal Rights Given

Child Care Parent Notification Requirements and Acknowledgement of Receipt of Licensing Reports (LIC9224) was also explained and provided to Licensee during today’s Inspection.



SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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 08/15/2023 04:37 PM - It Cannot Be Edited


Created By: Anna Morales On 08/15/2023 at 12:19 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: 434400342

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/16/2023
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision(a)(1) 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.
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Director stated that she has conducted a re-training on supervision, Child Supervision Record re-trainng/name to face transitions with staff on 8/7/23. Director stated that she will submit the plan along with staff's signature by the POC date.
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This requirement was not met as evidenced by: A child was left unattended inside the Lobby on August 3,2023. This is a zero tolerance violation. This poses an immediate risk to the health, safety, and personal rights to children in care.
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This is a zero-tolerance violation, an immediate civil penalty of $1,000.00 was assessed during the inspection. Upon receipt, Director shall post and provide copies of this licensing report, have LIC 9224 signed and kept on file, to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. According to AB 633, parents must be provided with this report which contains this Type A deficiency for the next 12 months & copy of the signed acknowledgment form must be kept in each child's file.

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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:Gladys Kuizon
LICENSING EVALUATOR NAME:Anna Morales
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2023


LIC809 (FAS) - (06/04)
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