<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709778
Report Date: 07/09/2021
Date Signed: 07/09/2021 11:09:00 AM

Document Has Been Signed on 07/09/2021 11:09 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
430709778
ADMINISTRATOR:EVELYN CARRILLOFACILITY TYPE:
830
ADDRESS:860 N. HILLVIEW DRIVETELEPHONE:
(408) 263-0444
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 27TOTAL ENROLLED CHILDREN: 0CENSUS: 17DATE:
07/09/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:54 AM
MET WITH:Evelyn CarilloTIME COMPLETED:
11:15 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On Friday, July 9, 2021 at 9:54 AM, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Proof of Correction (POC) Visit. LPA met with the Director Evelyn Carillo and and the Assistant Director Lindsay Martin. Present on this visit were 7 infants, 10 toddlers and 7 staff.

LPA toured the facility for health and safety inspection. At 10:26 LPA observed the Infant Room, Toddler Room, Kitchen and the Staff Hallway Bathroom to be neat and clean and appeared no sign of insect infestation. At 10:23 am LPA observed an empty sticky insect trap behind the kitchen door. Director stated that it was a management decision to leave the sticky insect trap for future insect infestation prevention.

POC is due today, 07/09/2021 and cleared on the same day. LPA obtained copies of the the POC plan and document, staff, infant and toddler Child Supervision Record.

Director stated that the LIC 9224 Acknowledgement of Receipt of Licensing Reports is being completed and will send a a copy of the completion at the end of the day to LPA via email or will be mailed.

No regulatory violation observed today. No citation if being issued today.

An exit interview was conducted with the director. A Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 07/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1