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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005944
Report Date: 03/13/2025
Date Signed: 03/13/2025 03:43:32 PM

Document Has Been Signed on 03/13/2025 03:43 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198005944
ADMINISTRATOR/
DIRECTOR:		JENNIFER HOLLANDSWORTHFACILITY TYPE:
850
ADDRESS:5251 E. LAS LOMASTELEPHONE:
(562) 961-8882
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY: 117TOTAL ENROLLED CHILDREN: 117CENSUS: 104DATE:
03/13/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Assistant Director - Vivian FrancoTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced case management visit at the above mentioned address at 1:30 PM. LPA met with assistant Director Vivian Franco, who guided analyst on a tour. LPA observed 9 additional adults and 104 children in care. The facility was observed to be clean and free of defects.

The purpose of this visit is to review personnel records for staff members. During record review, LPA observed that 8 out of 9 staff members did not have a completed LIC 503 - Health Screening report signed by a licensed physician. LPA advised assistant director that a citation under California Code of Regulation (CCR) section 101217(a)(11) will be issued.

The following deficiency listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with assistant Director, Vivian Franco.
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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 03/13/2025 03:43 PM - It Cannot Be Edited


Created By: Randy Derraco On 03/13/2025 at 03:26 PM
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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 198005944

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/24/2025
Section Cited
CCR
101217(a)(11)

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101217 Personnel Records (a) The licensee shall ensure that personnel records are maintained on...each employee. Each personnel record shall contain the following information (11) A health screening as specified in Section 101216(g). This requirement is not met as evidenced by:
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POC Visit
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Based on observation, interview and record review, the licensee did not ensure health screening documentation was maintained on each employeed which poses a potential Health, safety and/or personal rights risk to persons 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:Denise Gibbs
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2025


LIC809 (FAS) - (06/04)
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