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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405917
Report Date: 01/05/2023
Date Signed: 01/05/2023 12:47:08 PM


Document Has Been Signed on 01/05/2023 12:47 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
197405917
ADMINISTRATOR:DEMI LARAFACILITY TYPE:
830
ADDRESS:1520 GREENWOOD AVENUETELEPHONE:
(310) 320-4429
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY:16CENSUS: 12DATE:
01/05/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Monica GonzalezTIME COMPLETED:
01:15 PM
NARRATIVE
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On 1/5/2023, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced Case Management – Incident inspection. LPA met with Director, Monica Gonzalez. LPA observed 12 infants with 6 staff.

Per the Unusual Incident Report submitted to the Department on 11/1/2022, on 10/25/2022 at around 11:00AM, Staff 1 tripped on a rug in the infant classroom and dropped Child 1. Due to the fall, Child 1’s lip was cut and bled. Staff 2 helped clean the blood off and provided an ice pack. Parents were notified at around 2:45pm.

On 11/2/2022, LPA Casillas interviewed Director and 6 staff. Per interviews, facility staff failed to notify Parent 1 of the incident immediately and Director failed to notify the Department of the incident within 24 hours.

Based on interviews and record review, LPA issued two Type B citations pertaining to parent notification of serious injuries and reporting requirements.

An exit interview was conducted, and a copy of this report, LIC 9213 Notice of Site Visit, and Appeal Rights were provided to Director, Monica Gonzalez.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:
DATE: 01/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/05/2023
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


Document Has Been Signed on 01/05/2023 12:47 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 197405917

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/05/2023
Section Cited

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101226 Health-Related Services (a) The licensee shall immediately notify the child's authorized representative if the child... sustains an injury more serious than a minor cut or scratch...

This requirement was not met as evidenced by:
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Director agreed to train staff on reporting injuries to the face or head of child to parents immediately as well as ensuring accurate information on written, hardcopy Ouch Reports provided to parents at pickup. Director agreed to provide a copy of the training agenda to LPA by 12:00PM on 1/6/2023.
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Based on interviews and record review, the facility failed to ensure Parent 1 was immediately notified of Child 1’s injury to the face, which poses an immediate health, safety, or personal rights risk to children in care.
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Type B
01/05/2023
Section Cited

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101212 Reporting Requirements (d) Upon the occurrence, during the operation of the child care center… a report shall be made to the Department by telephone… within the…next working day…
This requirement was not met as evidenced by:
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Director agreed to train staff on reporting requirements. Director agreed to provide a copy of the training agenda to LPA by 12:00PM on 1/6/2023.
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Based on interviews and record review, the director did not ensure that Unusual Incident Reports are reported to the Department within 24 hours via telephone, which poses a potential health, safety, or personal rights risk to 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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:
DATE: 01/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/05/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2