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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430700197
Report Date: 08/23/2024
Date Signed: 08/23/2024 01:12:44 PM

Document Has Been Signed on 08/23/2024 01:12 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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:KIDDIE KAMPUS DAY CARE CENTERFACILITY NUMBER:
430700197
ADMINISTRATOR/
DIRECTOR:		SUSAN COREYFACILITY TYPE:
850
ADDRESS:16330 LOS GATOS BOULEVARDTELEPHONE:
(408) 356-6776
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY: 171TOTAL ENROLLED CHILDREN: 171CENSUS: DATE:
08/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Susan Corey & Kelly KKnepperTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Jennifer "Jen" Beehler and Samantha Yip conducted an unannounced Case Management- Other inspection. LPAs met with Director Susan Corey and Assistant Director Kelly KKnepper and explained the reason for the inspection. The purpose of this inspection is to discuss the grassy lawn being used for recess time that was not licensed or approved for use.

LPAs observed the "White" classroom and "Yellow" classroom using the grass area. LPAs observed there was no fence surrounding this area. There were 25 children and 5 teachers present during this recess time.

LPAs reviewed the file to determine if the area had previously been licensed or was included in the building grounds, there was no documentation of this space in prior reports or facility sketches.

Due to today's observations, a Type B citation was issued. Director mentioned they will stop using the lawn area therefore the deficiency was cleared today.

An exit interview was conducted and the report was reviewed with the Site Director Susan. A notice of site visit was given and must be posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/23/2024 01:12 PM - It Cannot Be Edited


Created By: Jennifer Beehler On 08/23/2024 at 12:11 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: KIDDIE KAMPUS DAY CARE CENTER
FACILITY NUMBER: 430700197

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/26/2024
Section Cited
CCR
101161(a)

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Limitations on Capacity: A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement was not meant as evidenced by:
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Deficiency has been cleared, facility stopped using the lawn today.



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Based on observations and file review. The center was using the lawn area that was not fenced, located off of the "Green" room. The lawn area is not an approved area under the license.

This poses an immediate health and safety 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 Segura
LICENSING EVALUATOR NAME:Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2024


LIC809 (FAS) - (06/04)
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