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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417051
Report Date: 09/02/2025
Date Signed: 09/02/2025 11:12:44 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 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
08/29/2025 and conducted by Evaluator Andy Yang
COMPLAINT CONTROL NUMBER: 07-CC-20250829150642
FACILITY NAME:KINDERWOOD PRESCHOOLFACILITY NUMBER:
434417051
ADMINISTRATOR:FERNANDA VARGASFACILITY TYPE:
850
ADDRESS:5560 ENTRADA CEDROSTELEPHONE:
(408) 363-1366
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:69CENSUS: 26DATE:
09/02/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Fernada Vargas TIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Physical Plant - Staff are allowing day-care children to play on a hazardous play structure.
INVESTIGATION FINDINGS:
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On 9/02/2025, Licensing Program Analyst (LPA) Andy Yang conducted an unannounced complaint investigation. LPA met with Director, Fernanda Vargas to deliver the complaint allegation that staff are allowing day care children to play on a hazardous play structure. Present for today’s inspection were Director, Office Manager, (3) Teachers, (1) Aid, and (26) preschool age children. LPA toured the outdoor areas of the facility with Director.

LPA conducted an inspection of the play structure located in the preschool outdoor play area. The facility reported that a handyman was brought in to assess the tilt of the structure. Following the inspection, the handyman concluded that the play structure does not pose a potential risk to children and is considered secure for use. LPA observed that the play structure, which includes a swing set and a green slide, appears to be tilting to one side. Despite this, the structure is anchored securely to the ground.

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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
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 3
Control Number 07-CC-20250829150642
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINDERWOOD PRESCHOOL
FACILITY NUMBER: 434417051
VISIT DATE: 09/02/2025
NARRATIVE
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However, during the LPA’s inspection, it was observed that the upper section of the slide is not securely bolted to the play structure. Specifically, there is visible deterioration in the wood at the anchoring points, resulting in a gap where the bolts are attached. This condition indicates that the structure is not being maintained in a safe and secure manner.

LPA advised the Director to designate the play structure in the preschool outdoor play area as off-limits until appropriate repairs are completed. The Director agreed to ensure that staff provide close supervision to prevent children from accessing or using the play structure until it has been properly repaired or replaced.

Based on LPA’s observation and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED California Code of Regulations, 101239(o)(1), are being attached on the LIC 9099D. Appeal rights provided. A notice of site visit was given and must remain posted for 30 days.


Exit interview conducted and report was reviewed with the Director, Fernanda Vargas.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 07-CC-20250829150642
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: KINDERWOOD PRESCHOOL
FACILITY NUMBER: 434417051
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/02/2025
Section Cited
CCR
101239(o)(1)
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(o)Playground equipment shall be securely anchored to the ground unless it is portable by design. (1) Equipment shall be maintained in a safe condition, free of sharp, loose or pointed parts.
This Evidence was not met by:
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By Plan of Correction due date of 10/02/2025, Director shall make sure the play structure is maintained in a safe condition for children in care.
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Based on observation, and interviews, the preschool play structure has a slide that is not securley attached to the play structure which poses a potential health, safety or personal rights risk to persons 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: Belinda Devall
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3