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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014269
Report Date: 09/24/2021
Date Signed: 09/24/2021 04:51:24 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198014269
ADMINISTRATOR:JAYLEEN OLMOSFACILITY TYPE:
830
ADDRESS:4514 LARK ELLEN DR.TELEPHONE:
(626) 332-4001
CITY:COVINASTATE: CAZIP CODE:
91722
CAPACITY:12CENSUS: 12DATE:
09/24/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:09 PM
MET WITH:Jayleen Olmos, DirectorTIME COMPLETED:
04:00 PM
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On 9/24/2021 at 12:09PM, Licensing Program Analyst (LPA) Thelma Razo arrived at the facility to conduct an unannounced Required - 1 year inspection. LPA introduced self with Assistant Director Jessica Murphy and stated the purpose of the visit. At 12:35PM, Director Jayleen Olmos arrived from lunch break. LPA provided Director with a copy of the LIC 125 Entrance Checklist to facilitate the inspection. This is an infant program which consists of one classroom. Facility hours of operation is from Monday to Friday, 6:30 AM to 6:00 PM. This facility has a preschool component (Lic #198003049) and school age component (Lic #198003050).

LPA was guided to a facility tour by Director Olmos at 12:46PM. All areas identified on the Facility Sketch were inspected. The infant program is located adjacent to the center's pre-school program. The following staff were present during this inspection: Staff #1, Staff #2 and Staff #3 with 12 infants. The facility was observed to be within the license capacity and limitations. The following was observed during the tour of the facility:

Furniture and equipment were inspected for age appropriateness and good repair. The facility has sufficient napping equipment, feeding chairs, and changing tables. Infants in this program are from the age of 6 weeks to 24 months. Infants sleep on the cribs and toddlers on the cots. No infants were observed to be swaddled. Telephone service, heating, lighting and ventilation were evaluated. Infants have their own cubby to store their belongings. Bedding is provided by the facility and is washed at the end of the day, or as needed. Per Director, the isolation area is located in her office. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed. Availability of indoor drinking water was observed in the classroom.


Disinfectants, cleaning solutions, and other items that are dangerous to infants, were inaccessible to infants.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
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 CENTER
FACILITY NUMBER: 198014269
VISIT DATE: 09/24/2021
NARRATIVE
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Director states that there are no poisons stored at the facility. Carbon monoxide detector was observed and was not tested due to infants were napping. All food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin.

All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. Infants are on formula and soft foods. Brunch and snack menu was observed to be posted. Food in refrigerator was labeled. Sink counter tops were clean and free of clutter or standing food. Menus are posted one month in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request.

The outdoor playground was observed to be physically separate from the preschool component. Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. The outdoor surface is cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to infants were observed to be toxic free. Per Director, there are no firearms stored on the premises. There are no pools or bodies of water at the facility.

Children’s Records were reviewed. Infant Needs and Service plans were reviewed and observed to be in each file and renewed at least quarterly or as needed. Facility have a sleeping log in which infants are physically checked on by staff every 15 minutes. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in.

LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present have proof of TB negative test, measles, pertussis, and influenza. All staff have been given on the-job training sanitation principles, housekeeping, including universal health precautions. All individuals present have obtained a criminal record clearance or criminal record exemption as a condition of employment. All staff present were trained in CPR and Pediatric First Aid during this inspection.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
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 CENTER
FACILITY NUMBER: 198014269
VISIT DATE: 09/24/2021
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First Aid supplies were observed in the classroom in a back pack. According to the Director, there are currently no infants on medication.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

For additional information regarding the Compliance and Regulatory Enforcement (CARE) tools used for this inspection, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/tion-process.

There were no deficiencies cited during today’s inspection.

A Notice of Site visit was posted and must remain for 30 days.

Exit interview conducted and report was reviewed with Director Jayleen Olmos.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Thelma RazoTELEPHONE: (323) 981-3387
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
LIC809 (FAS) - (06/04)
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