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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401911
Report Date: 01/18/2023
Date Signed: 01/18/2023 02:55:20 PM

Document Has Been Signed on 01/18/2023 02:55 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:
073401911
ADMINISTRATOR:KATHY CONROWFACILITY TYPE:
850
ADDRESS:2850 CHERRY LANETELEPHONE:
(925) 943-6777
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94596
CAPACITY: 53TOTAL ENROLLED CHILDREN: 45CENSUS: 37DATE:
01/18/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kathy ConrowTIME COMPLETED:
11:30 AM
NARRATIVE
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On 1/18/23 Licensing Program Analyst (LPA) Monica Mathur met with Director, Kathy Conrow to conduct a Case Management inspection for the Lead Testing results at Kindercare Learning Center. District Leader, Diane Palacios was also present.

It was indicated that there were two (2) outlets which exceeded the Action Level established by the State for exposure. On 1/10/23 during a phone call with LPA Mathur, Director stated she was unaware of the exceedance results and did not know documents had to be submitted to Licensing Office within 2 weeks of sampling. Written Directives for Lead Testing PIN 21-21.1-CCP states copy of the following documents shall be sent by the Child Care Center licensee to the Licensing Program Analyst (LPA) within 2 weeks of the completed sampling date: (1) External Water Sampler Self-Certification Form (LIC 9275) for certified external water samplers. (2) Facility Sketch (LIC 999) fully labeled with the locations of all water outlets, including outlets that will not be sampled. (3) Child Care Center Sampling Checklist Form (LIC 9276).

Today, on 1/18/23 LPA conducted an inspection and toured the premises with Director, Kathy. LPA also met Facility Tech person, Ryan. Both Director and Ryan stated outlets located in the outdoor play yard, were used for drinking water prior to pandemic. Since pandemic facility ceased to use drinking fountains and children use water bottles. LPA observed outlets have been sealed off with plastic covers, made inaccessible to children. They plan to permanently remove the outlets and a work order has been placed.

Due to outlets being in use by children for drinking water before pandemic, children were potentially exposed to lead which is a risk to their health and safety. Deficiency is cited on page 809D). LPA discussed a Plan of Correction and facility has now submitted the documentation for the post-testing requirements.

Exit interview conducted and report was reviewed with the Director, Kathy Conrow. A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2023
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 01/18/2023 02:55 PM - It Cannot Be Edited


Created By: Monica Mathur On 01/18/2023 at 11:49 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 073401911

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
02/20/2023
Section Cited

101700.3(b)(2)

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Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care. This requirement is not met as evidenced by:
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LPA observed outlets have been sealed. Director states outllets will be removed permanently at a later date. Director has submitted plan of correction on steps taken.
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Per LPA's inspection, there are 2 drinking water outlets in outdoor yard with lead exceedance. Director states outlets have not been used since pandemic. Since they were in use before pandemic, this poses/posed potential risk to health/safety of children.
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BY 2/20/23 Director agreed to send photos of outdoor area showing outlets have been permanently removed.
Request Denied
Type B
01/18/2023
Section Cited
101703.3(a)

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101703 Post -Testing Requirements & Information (a) [...] copy of following shall be sent by the licensee to the Licensing Program Analyst (LPA) within 2 weeks of the completed sampling date: (1) External Water Sampler Self-Certification Form (LIC 9275) for certified external water samplers. (2) Facility Sketch (LIC 999) fully labeled with the locations of all water outlets, including outlets that will not be sampled. (3) Child Care Center Sampling Checklist Form (LIC 9276)
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Director has submitted documents LIC 9275, LIC9276, LIC999 via email on 1/13/23. Citation was cleared during inspection. Letter of Clearance provided.
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Facility failed to send documents within 2 weeks of sampling. Director states she was unaware of the requirement. This poses a potential risk to health safety of children 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.
SUPERVISOR'S NAME:Sherelle Johnson
LICENSING EVALUATOR NAME:Monica Mathur
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023


LIC809 (FAS) - (06/04)
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