434408011-6-6-2019-07-CC-MMOO-BCVMPS-20190606094738

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408011
Report Date: 06/05/2019
Date Signed: 06/06/2019 09:47:42 AM

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 CENTER		FACILITY NUMBER:	434408011
ADMINISTRATOR:	TRABANINO, CATHERINE		FACILITY TYPE:	830
ADDRESS:	1515 S. DE ANZA BLVD		TELEPHONE:	(408) 861-9510
CITY:	CUPERTINO	STATE: CA	ZIP CODE:	95014
CAPACITY:	28	CENSUS: 20	DATE:	06/05/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Catherine Trabanino		TIME COMPLETED:	02:40 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	Licensing Program Analyst (LPA), Marilou Monico, met with Site Director, Catherine Trabanino, and conducted a case management inspection in response to licensee's request to increase the capacity from 28 to 56 children and adding a classroom on the license. LPA toured the facility both inside and outside. The following measurements were taken by LPA Clifford on December 21, 2004: TODDLERS 1: 22.249 x 14.747 = 328.106 minus 12.670 (encumbered space) = 315.436 TODDLERS 2: 22.249 x 16.747 = 372.604 minus 49.031 (encumbered space) = 323.573 TODDLERS (previously Two's 1): 29.664 x 27.249 = 808.314 minus 207.028 (encumbered space) = 601.286 INFANTS: 37.830 x 21.166 = 800.709 minus 48.324 ( encumbered space) = 752.385 TOTAL INFANT/TODDLER INDOOR SPACE: 1992.68 divided by 35 = 56 children INFANT/TODDLER PLAYGROUND: 81.581 x 26.581 = 2168.504 TOTAL INFANT/TODDLER OUTDOOR SPACE: 2168.504 sq. ft. divided by 75 = 28 children There are 7 sinks (105) available for the children. There are two staff bathrooms. The staff bathroom located in the Reception Area will be utilized by the sick children if needed. The sick children will be isolated in the Director's office and isolated equipment is provided. Cleaning supplies are stored in a locked upper cabinet in each room. There is a kitchen at the facility for food preparation and is equipped with hot and cold running water, refrigerators, microwave, stove, oven, and dishwasher. There are solid waste containers throughout the facility for the disposal of solid waste. There are 72 cubbies, 56 chairs, 7 high chairs, 9 tables, and 44 cots for the daycare children. Drinking water indoor is via sippy cups and bottles. Each room has a diaper changing table within arm's reach of a sink. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 06/05/19):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 434408011
	VISIT DATE: 06/05/2019

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 06/05/19):

The infant program has its own yard. The playground is surrounded with appropriate fencing and the outdoor surfaces are safe. There is no climbing structure in the yard. There is a canopy in the yard for shade. Drinking water outdoor is via drinking fountains, sippy cups and bottles. LPA observed no bodies of water.

Fire clearance was granted on May 15, 2019.

As a result of this inspection, a license for 56 children in the infant program will be approved upon receipt of the following:
1) Waiver request to be licensed for 56 children even the playground is only measured for 28 and playground schedule..
2) Complete paperwork for licensee representative, Jennifer Liu: Applicant Information (LIC 215), Criminal Record Statement (LIC 508), Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108), Health Screening (LIC 503) with TB test, Proof of immunization in measles, pertussis, and influenza, Mandated Reporter Training certificate, and Proof of Orientations (Application and Operations/Record Keeping).

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

LIC809 (FAS) - (06/04)

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