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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005945
Report Date: 11/04/2020
Date Signed: 11/04/2020 11:29:31 PM

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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198005945
ADMINISTRATOR:BERNICE GONZALEZFACILITY TYPE:
830
ADDRESS:5251 E. LAS LOMASTELEPHONE:
(562) 961-8882
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY:56CENSUS: 8DATE:
11/04/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:Regina RamirezTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Case Management-Incident inspection. This inspection is regarding incident/injury that took place on October 28, 2020. Licensing Program Analyst met with Director Regina Ramirez.

Director Ramirez guided LPA to the area (Room 9) where the incident took place. LPA observed the area to be clean, free of hazards and appearing to be in safe good condition. LPA also observed the chairs and table to be age and height appropriate. Director Ramirez indicated she was called in to help provide immediate first aid after child #1 tripped and hit a chair (sustaining an injury to the face). Director Ramirez also called 911 and contacted Child #1's parents. Staff #1 indicated that child #1 tripped over their feet and hit their face on a chair sustaining and injury to the mouth. Staff #1 immediately helped to provide first aid and contacted the Director to assist with first aid.

Note: The child was reviewed by medical staff and released to the parents the same day. The child returned to school the next day with no restriction. The staff followed the required protocol in terms of first aid and "reporting requirements" as the 10/28/2020 incident was reported to Child Care Licensing within the required 24 hours. Information provided matches the incident report. Based on interviews and observations there were no violations of Title 22 requirements.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. This report will be sent to the Licensee via email with a read receipt to confirm receipt of the report. Exit interview was conducted with Director Ramirez.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2020
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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