013415775-8-13-2021-52-CC-CCHS-C5V2KQ-20210813172819

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013415775
Report Date: 08/13/2021
Date Signed: 08/13/2021 05:28:52 PM

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 CENTER		FACILITY NUMBER:	013415775
ADMINISTRATOR:	WOOLSEY, SIERRA		FACILITY TYPE:	830
ADDRESS:	11925 AMADOR VALLEY COURT		TELEPHONE:	(925) 875-0400
CITY:	DUBLIN	STATE: CA	ZIP CODE:	94568
CAPACITY:	36	CENSUS: 16	DATE:	08/13/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Scott Kinser, Assistant Director		TIME COMPLETED:	05:15 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	08/13/2021, at approximately 10:30am, Licensing Program Manager Chandra Charles, met with Assistant Director Scott Kinser, for a UNANNOUNCED REQUIRED RANDOM INSPECTION OF THE INFANT / TODDLER COMPONENT OF THIS COMBINATION DAY-CARE CENTER. Initially, present during the inspection were (2) staff personnel, (4) infants and 12 toddlers. Licensing Program Manager Chandra Charles, toured the three classrooms for a Health and Safety Inspection. Infant room A is currently not be used. Infant room B had (1) teacher and (4) infants and the toddler room had (12) children and (1) teacher. All children are under visual supervision. Teacher-child ratio was observed. CLASSROOMS: There are adequate play and learning materials available. Furniture and equipment is age appropriate and in good repair. There is adequate heating, ventilation and lighting. There is proper individual storage space for each child belongings. There are carbon monoxide detectors in each classrooms. LPM Charles, observed 8 cribs in the infant room 'A' and 12 cribs in infant room 'B'. All cribs had firm mattresses. In each room has are changing tables with connecting working sinks. There were age appropriate infant & toddler toys and floor equipment. The floors and the rugs were clean. In the infant classrooms there are refrigerators which, the children's bottle was kept. LPM did observe bottles in the refrigerators that were labeled with each child's name and date. At the end of the day unused bottle was returned to the parents. The infant rooms have low board leg food chairs for the staff to use when feeding the infants. RECORDS: A review of staff records on 08/13/2021 indicates that facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The staff records were reviewed and recorded under the Preschool component. (3) Infant files were reviewed and all required forms were in the facility files. LPM also observed each file had a current Needs & Service plan and a Individual Sleeping Plan.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

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 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 013415775
	VISIT DATE: 08/13/2021

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

POSTING
Required posting were posted in a public accessible area.

There are no bodies of water accessible to children. There are no firearms on the premises. Infants are being visually supervised. All storage areas for poisons are locked.

This facility is not providing Incidental Medical Services-IMS at this time. LPM discussed IMS services and the requirement to update the plan of operation. Specifics on the plan can be found in the child care center evaluator manual (CCC EM) Policy 101173.

Licensee was asked to go to our website at www.ccld.ca.gov to ensure that he is informed of all new quarterly updates on laws and regulations.

There are no deficiencies cited. 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 appeal rights provided.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2