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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417051
Report Date: 10/08/2025
Date Signed: 10/08/2025 10:12:18 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
09/03/2025 and conducted by Evaluator Andy Yang
COMPLAINT CONTROL NUMBER: 07-CC-20250903121943
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: 30DATE:
10/08/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Fernanda VargasTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Qualification - Unqualified staff providing care to day care children
INVESTIGATION FINDINGS:
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On 10/08/2025, Licensing Program Analyst (LPA) Andy Yang conducted an unannounced complaint investigation. LPA met with Director, Fernanda Vargas to deliver the complaint allegations as mentioned above. Present for today's inspection were Director, (3) staff, and (30) children. LPA toured the indoor and outdoor areas of the facility.

LPA reviewed records, conducted observations, and interviewed the Director and staff.

***Continue Page 2***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
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 5
Control Number 07-CC-20250903121943
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: 10/08/2025
NARRATIVE
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***Page 2***

It was reported that unqualified staff provides care to children. Based on records review, Staff 1 does not have educational requirements to be a fully qualified teacher. Through interviews conducted, it was stated that Staff 1 is sometimes left alone with children until a qualified teacher arrives. During an investigation conducted on 9/11/2025, LPA observed Staff 1 supervising (12) preschool children in care without a qualified teacher.

Based on LPA’s observation and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED California Code of Regulations, Title 22 101216.1(b)(1)(A), are being attached on the LIC 9099D.


A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.

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

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 07-CC-20250903121943
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: 10/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/17/2025
Section Cited
CCR
101216.1(c)(1)(A)
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(c) To be a fully qualified teacher, a teacher shall have one of the following: (c)Twelve post-secondary semester or equivalent quarter units in early childhood education...(A) The units specified in (c)(1) above shall include courses that cover the general areas... and program/curriculum. This requirement is not met as evidence by:
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By Plan of Correction Due date of 10/17/2025, Director will provide current teacher's schedule for Staff 1, and a letter of understanding that if a staff does not meet the requirements to be a qualified teacher, they must be supervised by a qualified teacher.
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Based on interviews, observation and records review, Staff 1 does not have required courses to be a qualified teacher, and was left supervising children without a qualified teacher, which poses a potential risk to the health and safety of children 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: Susy Cervantes
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5