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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417051
Report Date: 12/11/2024
Date Signed: 12/11/2024 04:54:48 PM

Substantiated


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
12/03/2024 and conducted by Evaluator Marilou Monico
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20241203123743
FACILITY NAME:KINDERWOOD PRESCHOOLFACILITY NUMBER:
434417051
ADMINISTRATOR:CHEYENNE BOHNFACILITY TYPE:
850
ADDRESS:5560 ENTRADA CEDROSTELEPHONE:
(408) 839-5669
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:69CENSUS: 38DATE:
12/11/2024
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Gireesh Malhotra & Fernanda Vargas-GuizarTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility play area pose a hazard to daycare children.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Marilou Monico and Andy Yang made an unannounced complaint investigation. LPAs met with Owner, Gireesh Malhotra, and Acting Site Director, Fernanda Vargas-Guizar, and explained to them the purpose of today's inspection.

LPAs toured the facility. LPAs observed broken play structures, metal screw not properly mounted on the wooden board between the turf and cemented area, deep hole on the ground under the rock climbing structure, and deteriorating wooden beam that supports the swing in the preschool outdoor play areas. Based on LPAs observation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

As a result, deficiency was cited on the following page.
Exit interview conducted and report was reviewed with Owner, Gireesh Malhotra, and Acting Site Director, Fernanda Vargas-Guizar.
A Notice of Site Visit was issued and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024
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-20241203123743
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: KINDERWOOD PRESCHOOL
FACILITY NUMBER: 434417051
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/03/2025
Section Cited
CCR
101238.2(d)(1)&(2)
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Outdoor Activity Space - The surface of the outdoor activity space shall be maintained:(1) In a safe condition for the activities planned. (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.
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Gireesh stated that he will have the items fixed or removed from the playground and will submit proof of correction to Licensing by 01/03/25.
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This requirement is not met as evidenced by: LPAs observed broken play structures, metal screw not properly mounted on the wooden board, deteriorating wooden beam, and deep hole on the ground under the rock climbing structure located in the preschool play areas. This poses a potential health, safety, and personal rights risks to 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: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024
LIC9099 (FAS) - (06/04)
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