Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434408011
Report Date: 04/16/2018
Date Signed: 04/16/2018 01:48:32 PM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/12/2018 and conducted by Evaluator Marilou Monico
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20180412120844
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434408011
ADMINISTRATOR:ANDREA KERNFACILITY TYPE:
830
ADDRESS:1515 S. DE ANZA BLVDTELEPHONE:
(408) 861-9510
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY:28CENSUS: 17DATE:
04/16/2018
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Brittney GeerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff handled children roughly.
Staff restrained children.
No qualified director.
Facility operating out of ratio.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs), Marilou Monico and Angelita Estapia, met with Acting Director, Brittney Geer, and discussed the above allegations. LPAs toured the facility, interviewed staff, and reviewed staff files. LPAs learned that a staff member handled children roughly by picking them up under their arms and sat them hard on the foam mat during circle time when a child/chidren ran away from the group. LPAs learned that a staff member was pushing her foot against a child's chair towards the table to prevent a child from standing while waiting for lunch. Staff were placing four children in a wagon with maximum capacity of two per manufacturer's recommendation. Based on interviews and file reviews, there were few times in the past and since the intercom were broken that teacher/teacher's aide was left alone with more than 4 infants. Previous director, Andrea Tran, left the facility on March 16, 2018. Acting Director is missing units to be a qualified infant director. The above allegations are substantiated.

Deficiencies were cited on the following pages:
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2018
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 4
Control Number 07-CC-20180412120844
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/17/2018
Section Cited
CCR
101223(a)(3)
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PERSONAL RIGHTS - LPAs learned that a staff member handled children roughly by picking them up under their arms and sat them hard on the foam mat during circle time.
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Acting Director states that an all staff meeting/training will be conducted to discuss positive discipline. Written plan to be sent to Licensing by 04/17/18.
Type A
04/17/2018
Section Cited
CCR
101223(a)(2)
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PERSONAL RIGHTS - A child was restrained on a chair and staff packed four children in a wagon with a maximum capacity of two per manufacturer's recommendation.
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Acting Director states she will cover the issue on restraining on their staff meeting/training and will notify staff to place only a maximum of two children per wagon. Written plan to be sent to Licensing by 04/17/18.
Type A
04/17/2018
Section Cited
CCR
101416.5(b)
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Staff-Infant Ratio - LPAs learned that there were few times in the past and since the facility's intercom system was broken that a teacher/teacher's aide was left alone with more than 4 infants (children under two years old).
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Acting Director states she will submit a written plan to maintain the required ratio at all times. Written plan to be sent to Licensing by 04/17/18.
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Upon receipt, licensee shall post and provide copies of this licensing report 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.
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: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2018
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 07-CC-20180412120844
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/23/2018
Section Cited
CCR
101415(a)
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Infant Care Center Director Qualifications and Duties - The facility has no qualified director.
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Acting Director states that the new director will start on May 7, 2018 and will submit paperwork to Licensing. Written plan of correction to be sent to Licensing by 04/23/18.
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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: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2018
LIC9099 (FAS) - (06/04)
Page: 3 of 4