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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313605049
Report Date: 03/08/2021
Date Signed: 03/09/2021 07:55:43 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:KINDERCARE LEARNING CENTER - SUNSET (SA)FACILITY NUMBER:
313605049
ADMINISTRATOR:TARA ROZAKFACILITY TYPE:
840
ADDRESS:2251 SUNSET BLVDTELEPHONE:
(916) 315-3399
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY:42CENSUS: 14DATE:
03/08/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Tara RozakTIME COMPLETED:
01:45 PM
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On 03/08/2021, Licensing Program Analyst (LPA) Jeremey McClain met with Director Tara Rozak via Facetime Video for a Case Management Inspection regarding an Unusual Incident Reported received via email on February 23, 2021.

Upon arrival, LPA observed 14 school age children, supervised by two staff members.

It was reported that on February 17th, 2021 a child in care fractured a bone in their leg while in a classroom. Prior to the injury, the child was feeling ill and vomited on themselves. The teacher noticed the injury after he had gathered paper towels to clean up the vomit. The child’s father arrived to pick them up and reported later that day that the child has suffered a broken leg. Staff did not know how or when the child suffered the injury, but it is believed the child may have slipped in their vomit.

During today’s inspection, LPA observed the area the incident occurred, and conducted interviews with the director and teacher who were there during the incident.

It was determined that there were no violations of Title 22 regulations.

This report was emailed to the Director for review and signature. A Notice of Site Visit was also emailed, which must remain posted for 30 days.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2021
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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