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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401902
Report Date: 04/20/2023
Date Signed: 04/20/2023 06:07:12 PM


Document Has Been Signed on 04/20/2023 06:07 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
073401902
ADMINISTRATOR:CHRISTINA RODRIGUEZ-PENAFACILITY TYPE:
850
ADDRESS:1285 MORELLO AVENUETELEPHONE:
(925) 372-7701
CITY:MARTINEZSTATE: CAZIP CODE:
94553
CAPACITY:60CENSUS: 36DATE:
04/20/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:CHRISTINA RODRIGUEZ-PENATIME COMPLETED:
06:30 PM
NARRATIVE
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 Licensing Program Analyst Tasha Alexander met with Center director Christina Rodriguez-Pena for an UNANNOUNCED CASE MANAGEMENT inspection. Today there are 36 children present along with 5 staff. The purpose of this inspection is to follow up on lead testing results that exceeded 5.5 ppb.

LPA toured the facility and reviewed documents. The facility has replaced the bubbler head and hose on the outlet, and LPA verified by inspecting the location.

See 809-D for deficiency being cited today.

An exit interview was conducted with Ms. Rodriguez-Pena and a copy of the report and appeal rights were provided. A notice of Site visit was given to Licensee, and Licensee was reminded that it needs to be posted for 30 days

SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2023
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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Document Has Been Signed on 04/20/2023 06:07 PM - It Cannot Be Edited

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, SUITE 1102
OAKLAND, CA 94612


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 073401902

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/21/2023
Section Cited

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101700.3(b)(1) Lead Testing Written Directive A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance

This requirement has not been met as evidenced by record review. The licensee did not comply with the section cited above which poses a potential Health and Safety risk to persons in care.
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THE FACILITY HAD THE BUBBLER HEAD AND HOSE REPLACED ON THE FAUCET .

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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.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2023
LIC809 (FAS) - (06/04)
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