Preparing mechanical systems in their lowest possible entropy state, the quantum ground state, starting from a room temperature environment is a key challenge in quantum optomechanics. This would not only enable creating quantum states of truly macroscopic systems, but at the same time also lay the groundwork for a new generation of quantum-limited mechanical sensors in ambient environments. Laser cooling of optomechanical devices using the radiation pressure force combined with cryogenic precooling has been successful at demonstrating ground state preparation of various devices, while a similar demonstration starting from a room temperature environment remains an outstanding goal. Here, we combine integrated nanophotonics with phononic band gap engineering to simultaneously overcome prior limitations in the isolation from the surrounding environment and the achievable mechanical frequencies, as well as limited optomechanical coupling strength, demonstrating a single-photon cooperativity of 200. This new microchip technology allows us to feedback cool a mechanical resonator to around 1 mK, near its motional ground state, from room temperature. Our experiment marks a major step toward accessible, widespread quantum technologies with mechanical resonators.