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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417052
Report Date: 09/27/2022
Date Signed: 09/27/2022 04:51:50 PM

Document Has Been Signed on 09/27/2022 04:51 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
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: 30TOTAL ENROLLED CHILDREN: 30CENSUS: DATE:
09/27/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Gireesh MalhotraTIME COMPLETED:
05:00 PM
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On 09/27/2022 at 3:00 PM, Licensing Program Manager (LPM), Diana Stephenson, and Licensing Program Analyst (LPA), Janette Cruz, conducted a scheduled informal meeting at the San Jose Regional Office with Applicant, Gireesh Malhotra, to review missing/corrections needed on the change of ownership application. Also present is Applicant’s wife/current facility director of ABC Preschool & Daycare (015700561) and Footsteps Preschool (434414537), Anupama Malhotra,

LPM Stephenson reviewed with Applicant, the needed requirements for an infant center director. Applicant stated that current Infant Director for Kinderwood Child Development Inc (430710584) will take over and submit required documents to complete her director qualifications. LPM also informed Applicant that the facility needs two directors for the infants (30 children requested). Applicant will need to submit completed director packets.
LPM discussed with Applicant the documents that need to be updated and submitted, including but not limited to LIC 215, LIC 508, Board of Resolution, LIC 309, LIC401, LIC500, LIC 610, Corporation documents, director qualifications, Job Descriptions, Employee Handbook, Parent Handbook, Control of property, Plan of Operations, in order for the application to be complete.

LPM gave Applicant a list of needed corrections on their application. A copy of the Child Care Regulations (Admission Agreements, Food Services, Plan of Operations, Director and Assistant Director Qualifications) were provided to Applicant. Applicant will have 30 days from today's date to turn in all corrections/documents requested.

Exit interview conducted and report was reviewed with the Applicant, Gireesh Malhotra.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2022
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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