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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197403568
Report Date: 05/31/2022
Date Signed: 05/31/2022 05:33:55 PM

Document Has Been Signed on 05/31/2022 05:33 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
197403568
ADMINISTRATOR:GENESIS BENITEZFACILITY TYPE:
830
ADDRESS:44400 FOXTONTELEPHONE:
(661) 948-1767
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 7DATE:
05/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:27 AM
MET WITH:Genesis BenitezTIME COMPLETED:
01:13 PM
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Licensing Program Analyst (LPA) Lady King-Lewis conducted a Required 1 Year Inspection at the above facility. Upon arrival LPA was greeted by Director. The facility hours of operation 6:30 AM to 6:30 PM Monday thru Friday.

During the inspection LPA observed the facility Physical Plant, Care and Supervision, Facility Records Review, and Facility Administration.



LPA discussed safe sleep; and provided Child Care Licensing Safe Sleep web page as an additional resource:
www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep

Provided United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ for infant recall equipment.

Incidental Medical Services (IMS) policy was discussed. To provide Incidental Medical Services, such as administering blood glucose monitoring, inhaled medications, Epi-pen and Epi-pen Jr., insulin shots, gastrostomy tube feeding and care, or carrying out other medical orders, it is best practice to complete a “Plan for Providing Incidental Medical Services”. This plan will help you ensure that you can provide this service in the safest manner possible. A Plan for Providing IMS must be submitted to the Department.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Lady King
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 197403568
VISIT DATE: 05/31/2022
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Licensee is aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within 24 hours of incident by telephone and in writing within 7 day of incident on the form LIC624 per the regulation. The report unusual incident/injuries report should be emailed to UnusualIncidentReport@dss.ca.gov

During this inspection facility was observed to be in compliance with Title 22.

For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with the licensee a copy of this report and a notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Lady King
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
LIC809 (FAS) - (06/04)
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