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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709778
Report Date: 10/13/2021
Date Signed: 10/13/2021 10:14:54 AM

Document Has Been Signed on 10/13/2021 10:14 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: 27CENSUS: 18DATE:
10/13/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:27 AM
MET WITH:Evelyn Carillo TIME COMPLETED:
10:20 AM
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On Wednesday, October 13, 2021 at 09:37 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Case Management Visit. LPA met with the Director Evelyn Carillo and explained the nature of the site visit. Present on this visit were 7 staff, 6 infants and 12 toddlers. Facility operates from Monday and Friday 7:30 AM to 5:30 PM.

On 07/01/2021 visit, a Deficiency Type A Violation Cited CCR 101223(a)(2) and Proof of Correction Clearance on 07/09/2021. The facility requested an Appeal amending the Deficiency Type A Violation to a Type B Violation. LPA discussed with Director that the Appeal requested was approved by the Regional Manager Anika Evans.

LPA also discussed the Section cited will be corrected and amended from CCR 101223(a)(2) Personal Rights to CCR 101238(a)(1) Buildings and Grounds.

Director understood, agreed and signed the Amended LIC 9099's.

There are no deficiencies cited on this visit.

This report shall remain on file for 3 years.

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

Exit interview conducted and report was reviewed with the Director Evelyn Carillo.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2021
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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