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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003051
Report Date: 06/23/2022
Date Signed: 06/23/2022 10:29:03 AM


Document Has Been Signed on 06/23/2022 10:29 AM - 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198003051
ADMINISTRATOR:MARYAM MASSOUDIFACILITY TYPE:
850
ADDRESS:1650 STONER CREEKTELEPHONE:
(626) 965-3550
CITY:CITY OF INDUSTRYSTATE: CAZIP CODE:
91748
CAPACITY:48CENSUS: 36DATE:
06/23/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:43 AM
MET WITH:Marisa MoralesTIME COMPLETED:
10:35 AM
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Case Management inspection conducted by Licensing Program Analyst Jennifer Hua. LPA met with Lead Teacher Marisa Morales. Per teacher, Director and Assistant Director are not present during this visit. The purpose of this visit is to follow up on the incident the was reported to the Department on 6/9/22. Upon arrival, students were taking picture. Per lead teacher, today is picture day.

Interviews were conducted with staff.

Based on interviews conducted, no deficiency is cited at this time.

An exit interview conducted with lead teacher, copy of report given. Notice of Site Visit form was provided. Notice shall be posted for 30 days in an area accessible for review. Failure to post shall result in a $100 civil penalty.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/23/2022
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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