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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417052
Report Date: 12/26/2024
Date Signed: 01/06/2025 05:25:50 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-20241203095426
FACILITY NAME:KINDERWOOD PRESCHOOLFACILITY NUMBER:
434417052
ADMINISTRATOR:CHEYENNE BOHNFACILITY TYPE:
830
ADDRESS:5560 ENTRADA CEDROSTELEPHONE:
(408) 839-5669
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:30CENSUS: 3DATE:
12/26/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Fernanda VargasTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Staff does not ensure facility is operating in ratio.
Staff does not ensure other staff are qualified to care and supervise daycare children.
Staff are commingling daycare children.
INVESTIGATION FINDINGS:
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[This is an amended report from the Complaint Investigation Report (LIC 9099) dated 12/26/24]
Licensing Program Analyst (LPA) Marilou Monico made a follow-up complaint investigation and to deliver findings. LPA met with Acting Site Director, Fernanda Vargas. Based on interviews, record review, and evidence gathered during the investigation process, the Department concludes that the facility was out of ratio, unqualified staff supervising daycare children, and staff were commingling children. The above allegations are thus found to be SUBSTANTIATED, meaning the allegations are valid because the preponderance of the evidence standard has been met.

Type A and Type B deficiencies are being cited on the attached LIC 9099-D.

Exit interview conducted and report was reviewed with the Acting Site Director, Fernanda Vargas.

Notice of Site Visit was issued and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
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 4
Control Number 07-CC-20241203095426
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: 434417052
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/27/2024
Section Cited
CCR
101416.5(b)
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Staff-Infant Ratio - (b) There shall be a ratio of one teacher for every four infants in attendance.

This requirement was not met as evidenced by:
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By POC due date: 12/27/24, the Licensee to submit a written plan to maintain the required teacher-child ratio at all times.
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Based on interviews, record review and evidenced gathered, the facility did not maintain the teacher-child ratio. This posed an immediate risk to the health, safety, and personal rights to children in care.
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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.
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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: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 07-CC-20241203095426
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: 434417052
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/30/2024
Section Cited
CCR
101416.2(c)(1)(A)
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Infant Care Teacher Qualifications and Duties - (c) To be a fully qualified infant care teacher, a teacher shall have the following: (1) Completion, with passing grades, of 12 postsecondary semester or equivalent quarter units in early childhood or child development education at an accredited or approved college or university. (A) At least three of the units required in (c)(1) above shall be related to the care of infants or shall contain instruction specific to infants.
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By POC due date: 12/30/24, a written plan to be sent to Licensing to ensure that infants will be supervised by qualified staff.
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This requirement is not met as evidenced by: Based on interviews and record review, infants were supervised by unqualified staff which posed a potential risk to the health, safety, and personal rights to children in care.
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Type B
12/30/2024
Section Cited
CCR
101161(a)
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Limitations on Capacity - (a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
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By POC due date: 12/30/24, Licensee to submit a written plan on how they will ensure that children from different programs will be physically separated.
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Based on interviews, record review, and evidenced gathered, staff were commingling children from different programs which poses a potential health, safety or personal rights risk 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.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4