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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400332
Report Date: 07/02/2024
Date Signed: 07/03/2024 09:17:50 AM

Document Has Been Signed on 07/03/2024 09:17 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
434400332
ADMINISTRATOR/
DIRECTOR:		LYNDA NGUYENFACILITY TYPE:
830
ADDRESS:3320 SAN FELIPE ROADTELEPHONE:
(408) 270-0980
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 10DATE:
07/02/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:49 AM
MET WITH:Lynda NguyenTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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 07/02/2024 at 8:59am, Licensing Program Analyst (LPA), Farida Raja, met with Director, Lynda Nguyen, for an unannounced annual/random inspection in the Infant Program. The facility is licensed to serve children 6 weeks to 2 years in two classrooms. The facility has one waiver for shared outside playground space between the infants and one preschool class (2–3-year-olds in Discovery Room). Preschool (#434400334) and school age license (#434400333) are on the same premises. LPA observed the required posted materials including daily schedule, weekly menu and activity plan and emergency disaster plan in each class. Days and hours of operation are currently Monday-Friday, 6:30 am to 6:00 pm.

LPA and Director toured the indoor and outdoor areas of the Infant Program and observed the following ratios:
Infant (6 weeks to 1 year): 1 teacher and 4 infants.
Toddler (1-2 years): 2 teachers and 6 children.

Facility was in compliance with teacher to children ratio requirement. Classrooms, staff restrooms, kitchen and office area were inspected. Facility has central heating/cooling for comfort of children. Director states that there are no weapons or firearms on the premises. There is a working telephone at the facility (408-270-0980). Disinfectants, cleaning products and medicines were stored inaccessible to the children in care. All cabinets and drawers used for storage were locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. LPA observed solid waste containers with tight-fitting lids in the rooms. Floors were clean and free from tripping hazards. LPA observed appropriate changing tables that have raised sides (3 inches in height) and have vinyl changing pads that are at least 1 inch thick. LPA observed a trash can with tight fitting cover for the disposal of diapers. Napping mats and cribs are appropriate. Medications for children in each classroom are stored within locked boxes in locked cabinets. Sinks for children were observed to be safe, sanitary, and in working condition. Staff has one separate bathroom that can be utilized by sick children if needed.

Continued on Page 2
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400332
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
LPA observed fire extinguishers, working smoke and carbon monoxide detectors, and fire pull stations. The facility has a built-in smoke detector/ fire system. Log shows that the last Fire Drill was conducted on 02/07/2024 which is compliant with the six-month requirement for facilities.

Drinking water is readily available for the children in each room and in the outdoor playground area via individual water bottles, sippie cups or water pitcher/disposable cups. Water lead testing was completed by the facility on 10/25/2022 and retested on 3/25/2023.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Food storage and preparation areas were observed to be sanitary. The kitchen and storage area is clean and free of litter and rubbish. Foods and beverages were stored safely to prevent contamination and spoilage. All food and beverages that require refrigeration are stored in covered containers at 45 F. The facility provides breakfast, lunch and PM snack everyday. The menu is in writing and posted for the whole month and is accessible to authorized representatives. Infant food provided by parents is stored in the infant classroom.

The outdoor area of the facility was inspected and observed to be fenced in. Playground and play equipment were inspected and observed to be age appropriate and free of hazards. Areas around and under high climbing equipment and slides were cushioned with resilient material that absorbs falls. Shade was provided by canopy, play structures and building overhangs. There were no bodies of water observed. LPA advised Director about the ratios to maintain during water play activities.

Children sign in and out procedures and logs were reviewed. Children's Roster was reviewed, and a copy was provided to LPA. A sampling of 5 children's files were reviewed. All children's files were complete with all required documentation. Facility was in compliance with the Safe Sleep regulations/requirements, including the Infant Sleeping Plan (LIC 9227) and 15 minute checks and logs. Needs and Services Plans were observed in all children's files.

Continued on Page 3
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400332
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed two staff files. Staff S2 does not have fingerprint clearances. LPA observed a clearance transfer request (LIC 9182) submitted to CCL but staff did not have cleared fingerprint record to be associated to this facility. LPA advised Director to follow-up once an LIC 9182 has been submitted to ensure that staff is cleared and associated prior to having them work with children. At least one staff member on site has a current CPR and First Aid certification on file. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). Through file review, LPA observed that staff S1 does not have proof of immunization's for Tdap and Staff S2 does not have immunization proof for pertussis and measles. Staff S1 does not have the required infant toddler development units and is not a fully qualified infant toddler teacher. Director stated that staff completed the infant toddler class but was unable to provide proof of completion. LPA observed the required Mandated Reporter Training on file for both staff.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Director is encouraged to visit the Department’s website at www.ccld.ca.gov to access resources for providers, Title 22 Regulations, online option to pay annual license fee, adoption of new laws, etc.

Incidental Medical Services (IMS) policy was discussed. Director stated that no children require medication or IMS at this time. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. Any medications at the Facility are stored in each classroom inaccessible to children in care. Isolation of sick child was discussed, and Director explained that sick children will be isolated in the director's office/lobby area and isolation equipment will be provided.

Continued on Page 4
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400332
VISIT DATE: 07/02/2024
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
26
27
28
29
30
31
32
 A staff restroom which is off limits to other children is used if necessary. Child is always under visual supervision while in care of the facility. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility does not provide transportation to children in the infant program. LPA reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping. Each classroom has a first aid/emergency bag that is taken outdoors during outside play time.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list. childcareadvocatesprogram@dss.ca.gov. Child Care Advocate Program: https://cdss.ca.gov/inforesources/child-care-licensing/child-care-advocates.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Type A and Type B deficiencies were cited today on the attached LIC 809D pages. Civil Penaltiy was assessed in the amount of $500 on the attached LIC 421BG form. Appeal rights were printed and provided to Licensee. Due to the issuance of a Type A Citation during today's inspection, a copy of this Licensing Report must be given to each existing parent by the end of today or next day child is in care, and to any newly enrolled parents/guardians enrolled over the next 12 months from the date of this report. In addition, a copy of the LIC 9224 Acknowledgement of Receipt of Licensing Reports must be signed by each parent and kept in each child's file to confirm receipt of licensing report. LPA reminded Licensee that failure to correct deficiencies by Plan of Correction Due Date may result in civil penalties.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 07/03/2024 09:17 AM - It Cannot Be Edited


Created By: Farida Raja On 07/02/2024 at 12:40 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: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400332

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170e(1)
101170 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department


This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above fro one staff (S2) which poses an immediate health, safety or personal rights risk to persons in care. Director provided proof of clearance transfer request submitted to CCL but staff was not cleared and therefore was unable to be associated to the facility. Director had staff complete the fingerprint process during today's inspection.
POC Due Date: 07/03/2024
Plan of Correction
1
2
3
4
Director will submit a plan of correction to LPA by 07/03/2024.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/02/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 07/03/2024 09:17 AM - It Cannot Be Edited


Created By: Farida Raja On 07/02/2024 at 01:12 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: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 434400332

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, record review and interview, the licensee did not comply with the section cited above for two staff, S1 and S2 which poses a potential health, safety or personal rights risk to persons in care. Staff S1 does not have proof of immunization's for Tdap and Staff S2 does not have immunization proof for pertussis and measles.
POC Due Date: 07/16/2024
Plan of Correction
1
2
3
4
Director will submit immunization proof for two staff to LPA by plan of correction date of 07/16/2024.
Type B
Section Cited
CCR
101416.2(c)(1)(A)
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.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation , interview and record review, the licensee did not comply with the section cited above for one staff (S1) which poses a potential health, safety or personal rights risk to persons in care. Staff S1 does not have the required infant toddler development units and is not a fully qualified infant toddler teacher. Director stated that staff completed the infant toddler class but was unable to provide proof of completion during today's inspection.
POC Due Date: 07/16/2024
Plan of Correction
1
2
3
4
Director will submit transcipt/ CDA certification providing proof of completed units and a plan of correction to LPA by 07/16/2024.
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:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/02/2024


LIC809 (FAS) - (06/04)
Page: 6 of 6