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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417052
Report Date: 09/07/2023
Date Signed: 09/07/2023 04:23:07 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/19/2023 and conducted by Evaluator Janette Cruz
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230719154854
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:30CENSUS: 28DATE:
09/07/2023
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Valerie Castelo & Gireesh MalhotraTIME COMPLETED:
02:32 PM
ALLEGATION(S):
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Staff are not supervising children at all times.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Janette Cruz conducted an unannounced complaint investigation and met with Valerie Castelo, Director and Gireesh Malhotra, Licensee. Purpose of today’s inspection: deliver investigation findings.

Based on the available evidence, record reviews and interviews conducted, it was discovered that a daycare child was bitten by another child in multiple occasions. The preponderance of evidence standard has thus been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 12 & Chapter 1), is being cited on the attached LIC 9099-D. Copy of appeal rights provided to Director and Licensee, prior to conclusion of today’s inspection.

LPA discussed the requirements of AB633 to Director and provided her the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and director understands the requirements. Upon receipt, licensee/director shall post and provide copies of this licensing report to parents/guardians of children in care and to parents/guardians of children newly enrolled at the facility during the next 12 months.

Exit interview conducted and report was reviewed with Valerie Castelo, Director.
A Notice of Site Visit is given and must be posted near the entrance of the facility along with a copy of today's report for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 07-CC-20230719154854
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 PRESCHOOL
FACILITY NUMBER: 434417052
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/08/2023
Section Cited
CCR
101429(a)(1)
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101429 Responsibility for Providing Care and Supervision for Infants
(a) In addition to Section 101229, the following shall apply:
(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This requirement was not met as evidenced by:
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Licensee will submit to LPA Cruz a proof of in-service training conducted to staff regarding Responsibility for Providing Care and Supervision on Infants / Biting Policy and Prevention. Licensee will also submit to LPA a written plan of action indicating what steps will be implemented to ensure that infant biting incident can be prevented by POC due date.
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Based on observation, interviews and record reviews, a day care child was bitten on multiple occasions which posed an immediate health, safety or personal rights risk to persons 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.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023
LIC9099 (FAS) - (06/04)
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